OBJECTIVETo compare the efficacy of midazolam and diazepam for treatment of acute seizures in children.

METHODSOne hundred and twenty children with acute seizures were randomly divided into two groups: midazolam (0.1-0.3 mg/kg) and diazepam treatment (0.3-0.5 mg/kg) (n=60 each). In cases with seizure recurrence or statural convulsivus, a maintenance dose of midazolam (1-8 mg/kg per hour) and a maintenance dose of diazepam (0.5-1 mg/kg per hour) or along with phenobarbital sodium were given in the midazolam and diazepam treatment groups, respectively. The therapeutic effects were compared between the two groups.

RESULTSThe seizures were relieved in all cases from the two groups 10 minutes after administration of midazolam or diazepam. There were no significant differences in the average time of seizure control between the two groups. Five children in the midazolam group had seizure recurrence or statural convulsivus after 10 minutes compared with 13 children in the diazepan group (P<0.05). The time of seizure control averaged 40+/-32 minutes in the midazolam group compared with 69+/-24 minutes in the diazepam group after maintenance treatment (P<0.05). No midazolam and diazepam treatment related adverse events were observed.

CONCLUSIONSMidazolam is safe and effective in the treatment of acute seizures in children. Midazolam appears to be a better option in the treatment of recurrent seizures or statural convulsivus than diazepam.

Acute Disease ; Anticonvulsants ; therapeutic use ; Child ; Child, Preschool ; Diazepam ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Midazolam ; adverse effects ; therapeutic use ; Seizures ; drug therapy

We report a case of early resolution of convergence spasms following the addition of antipsychotic medications and present it as a possible alternative to the conventional treatment for convergence spasms. The cessation of atropinization of the eyes and the use of reading glasses was achieved after only 2 months following the initiation of antipsychotic medications for childhood emotional disorder.
Affective Symptoms/*drug therapy ; Anti-Anxiety Agents/therapeutic use ; Antipsychotic Agents/*therapeutic use ; Child ; Diazepam/therapeutic use ; E ; Female ; Fixation, Ocular ; Humans ; Serotonin Uptake Inhibitors/therapeutic use ; Sertraline/therapeutic use ; Treatment Outcome ; Visual Acuity

Paradoxical therapy consists of suggesting that the patient intentionally engages in the unwanted behaviour such as performing compulsive ritual or wanting a conversion attack. In this study, the subjects were selected by the emergency unit psychiatrist from patients who were admitted to the emergency unit with pseudoseizure. The diagnoses was based on DSM-IV criteria. Paradoxical intention was applied to half of the 30 patients with conversion disorders; the other half were treated with diazepam in order to examine the efficiency of the paradoxical intention versus diazepam. In both groups the differences of the anxiety scores at the beginning of the study were found to be insignificant (z=1.08, p=0.28). Of the 15 patients who completed paradoxical intention treatment, 14 (93.3%) responded favorably to paradoxical intention. On the other hand of 15 patients who completed diazepam therapy, 9 (60%) responded well to therapy and 6 patients carried on their conversion symptoms at the end of 6 weeks. Paradoxical intention-treated patients appeared to have greater improvements in anxiety scores (z=2.43, p<0.015) and conversion symptoms (t=2.27, p=0.034) than the diazepam-treated patients. The results of the present study are encouraging in that paradoxical intention can be effective in the treatment of conversion disorder.
Adolescent ; Adult ; Anticonvulsants/*therapeutic use ; Anxiety ; Anxiety Disorders/therapy ; Conversion Disorder/*therapy ; Diazepam/*therapeutic use ; Female ; Human ; Male ; Psychotherapy ; Seizures/*diagnosis/*therapy ; Wounds and Injuries

We present a case of delirium tremens lasting for five weeks in an alcohol-dependent individual. The patient required high-dose benzodiazepines, which is atypical and rare. The clinical presentation and management of this patient is discussed.
Adult ; Alcohol Withdrawal Delirium ; diagnosis ; drug therapy ; psychology ; Anti-Anxiety Agents ; therapeutic use ; Diagnosis, Differential ; Diazepam ; therapeutic use ; Humans ; Liver Cirrhosis ; diagnosis ; Male ; Mental Status Schedule

Tetanus is uncommon in Korea due to the introduction of vaccination programs and advances in public health. A case of maternal tetanus occurred on the 9 day postpartum in a 29-yr-old woman, who had not received a 10-yr-booster of tetanusdiphtheria toxoid after receiving the primary series of tetanus-toxoid-containing vaccine. There has hitherto been no reports on maternal tetanus in Korea. This case illustrates that tetanus remains a medical problem, principally among nonand underimmunized adults. The only way to fully prevent this disease is to ensure adequate immunization in all adults.
Adult ; Anti-Anxiety Agents/*therapeutic use ; Diazepam/*therapeutic use ; Female ; Humans ; Hypnotics and Sedatives/*therapeutic use ; Immunization, Passive ; Korea ; Muscle Relaxants, Central/*therapeutic use ; *Postpartum Period ; Tetanus/*drug therapy/etiology/physiopathology ; Treatment Outcome

Acute Disease ; Adolescent ; Adult ; Anticonvulsants ; therapeutic use ; Antidotes ; therapeutic use ; Bridged-Ring Compounds ; poisoning ; Diazepam ; therapeutic use ; Drug Therapy, Combination ; Electroencephalography ; Female ; Humans ; Male ; Poisoning ; drug therapy ; Treatment Outcome ; Unithiol ; therapeutic use

OBJECTIVESeizure is a common emergency in children with complicated pathogeny. Seizures are usually caused by complicated etiology and fever and febrile seizure are the commonest causes. Repeated and permanent seizures can damage the brain. So it is important to take active and effective measures to control seizure and high fever. Because most seizures and fever take place at home or out of hospital and it is difficult to administer drugs intravenously, it is important to explore an easy, safe, quick and effective way to control and prevent both seizure and fever. The present study aimed to explore the efficacy and safety of rectal administration of mixed ibuprofen and diazepam (IBU-DZP) solution.

METHODS(1) Animal study on the pharmacokinetics in rabbits and pharmacodynamics in rats after rectal administration with the mixed solution and on the irritability of the mixed solution to rectum. (2) Clinical study: Pharmacokinetics of the mixed solution in children after rectal administration were investigated.

RESULTS(1) Animal study: IBU and DZP were both rapidly absorbed from rectum with a peak blood level of (11.7 +/- 1.2) min and (9.4 +/- 2.7) min in rabbits, respectively. The mixed solution could effectively prevent the severity of seizures induced by pentetrazole and significantly suppressed fever induced by yeast. There were no remarkable pathological changes in rectal tissues after repeated rectal administration of the mixed solution. (2) Clinical study: IBU and DZP rapidly reached their peak blood levels at about 30 min and 15 min respectively after rectal administration to the children. The peak values were (57.8 +/- 7.9) mg/L and (450.1 +/- 158.7) microg/L, respectively. In fact, both of them reached levels that were much higher than their therapeutic levels in serum just at 5 min after administration, their blood levels were (41.4 +/- 5.5) mg/L and (321.8 +/- 53.9) microg/L, respectively.

CONCLUSIONSIBU-DZP mixed solution administered rectally is an easy, safe, quick and effective way to control and prevent both seizure and fever.

Administration, Rectal ; Animals ; Child ; Child, Preschool ; Diazepam ; administration & dosage ; pharmacokinetics ; Drug Therapy, Combination ; Humans ; Ibuprofen ; pharmacokinetics ; therapeutic use ; Infant ; Rabbits ; Rats ; Rats, Wistar ; Seizures, Febrile ; drug therapy

OBJECTIVE: To investigate the effect of diazepam and modafinil on acute hepatic failure in mice. METHODS: Acute liver failure was induced in male Kunming strain mice by enterocoelia injecting the mice with D-GalN and LPS . The mice in the treatment groups were given corresponding drug 2 h before the administration of D-GalN and LPS, and the mice in the control group were given the same dose of distilled water. The 24-hour survival rate, serum alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were compared. Serum levels of TNF-alpha and IL-1 and the levels of SOD, MDA, GR, GSH, NO and NOS in the liver were determined. RESULTS: Treatment with diazepam increased the survival rate and improved liver histological feature. Diazepam inhibited the serum levels of ALT, AST, TNF-alpha and IL-1, and reduced levels of MDA, NO and NOS and increased levels of GR and SOD in the liver. Modafinil decreased liver histological feature, increased the serum levels of ALT, AST, TNF-alpha and IL-1, increased level of MDA, and inhabited levels of SOD and GR in the liver. CONCLUSION Treatment with diazepam may suppress the D-GalN/LPS-induced acute hepatic failure and modafinil may facilitate the acute hepatic failure.
Animals ; Benzhydryl Compounds ; adverse effects ; therapeutic use ; Diazepam ; adverse effects ; therapeutic use ; Galactosamine ; Lipopolysaccharides ; Liver ; pathology ; Liver Failure, Acute ; chemically induced ; drug therapy ; pathology ; Male ; Mice ; Modafinil ; Random Allocation