Effect of rescue medication on seizure duration in non-institutionalized children with epilepsy.

Federico Vigevanoa,  Fenella J. Kirkhamb, Bernd Wilkenc, Miquel Raspall-Chaured, Regina Greblae, Dawn Leef, Tamara Werner-Kiechleg , Lieven Lagaeh.  Effect of rescue medication on seizure duration in non-institutionalized children with epilepsy.  European Journal of Pediatric Neurology. In press.

Abstract

OBJECTIVES

Characterize the real-world management of and outcomes for children with epilepsy receiving rescue medication for prolonged acute convulsive seizures (PACS) in the community.

METHODS

PERFECT-3 (Practices in Emergency and Rescue medication For Epilepsy managed with Community-administered Therapy 3) was a European, retrospective observational study. Eligible patients were non-institutionalized children with epilepsy aged 3–16 years who had experienced ≥1 PACS in the past year and had ≥1 currently prescribed PACS rescue medication. Investigators provided clinical assessments and parents/guardians completed questionnaires. Statistical tests were post hoc; p values are descriptive.

RESULTS

At enrollment (N = 286), most patients had prescriptions for diazepam (69.2%) and/or midazolam (55.9%); some had two (26.6%) or three (2.4%) prescribed rescue medications. Most patients experienced PACS despite regular anti-epilepsy medication. According to parents, the average duration of their child’s seizures without rescue medication was <5 minutes in 35.7% of patients, 5–<20 minutes in 42.6%, and ≥20 minutes in 21.7% (n = 258); with rescue medication seizure duration was <5 minutes in 69.4% of patients, 5–<20 minutes in 25.6%, and ≥20 minutes in 5.0%. Rescue medication use was significantly associated with average seizures lasting <5 minutes (χ2 = 58.8; p < 0.0001). At the time of their most recent PACS, 58.5–67.8% of children reportedly received rescue medication within 5 minutes of seizure onset, and 85.4–94.1% within 10 minutes.

CONCLUSION

This study provides the first real-world data that rescue medications administered in the community reduce the duration of PACS in children with epilepsy. Study limitations including potential recall bias are acknowledged.

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From the article:

The duration of seizures both without rescue medication and when rescue medication was given was obtained from parents’ responses to two survey questions: ‘When your child experiences a prolonged seizure, on average how long does it last when no rescue medication has been given?’ and ‘When your child experiences a prolonged seizure, on average how long does it last after rescue medication has been given?’.Responses were based on parental recollections from the previous 12 months.

The clinicians described the real–world management of and outcomes for children with epilepsy, receiving rescue medication for prolonged acute convulsive seizures (PACS) in the community. It was noted that rescue medications administered in the community reduced the duration of PACS in children with epilepsy. Study limitations included the potential recall bias were acknowledged.

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Methods

PERFECT-3 (Practices in Emergency and Rescue medication For Epilepsy managed with Community-administered Therapy 3) was a European, retrospective observational study.

For this study, eligible patients were non-institutionalized children with epilepsy aged 3-16 years who had experienced ≥ 1 PACS in the past year and had ≥1 currently prescribed PACS rescue medication.

Investigators gave clinical assessments and parents/guardians completed questionnaires.

In this study, statistical tests were post hoc; p values were descriptive.

Results

Most patients had prescriptions for diazepam (69.2%) and/or midazolam (55.9%) at enrollment (N = 286); some had 2 (26.6%) or 3 (2.4%) prescribed rescue medications.

Despite regular anti-epilepsy medication, most patients experienced PACS.

The average duration of their child’s seizures without rescue medication was <5 minutes in 35.7% of patients, 5-<20 minutes in 42.6%, and ≥20 minutes in 21.7% (n = 258); with rescue medication seizure duration was <5 minutes in 69.4% of patients, 5-<20 minutes in 25.6%, and ≥ 20 minutes in 5.0% according to parents.

Rescue medication use was significantly correlated with average seizures lasting <5 minutes (Χ2 = 58.8; p < 0.0001).

58.5-67.8% of children reportedly received rescue medication within 5 minutes of seizure onset, and 85.4-94.1% within 10 minutes at the time of their most recent PACS.

https://www.mdlinx.com/neurology/medical-news-article/2017/08/07/epilepsy-midazolam-diazepam-prolonged-acute-convulsive/7270792/?category=latest&page_id=1