O'Dell Christine, Shinnar Shlomo, Ballaban-Gil Karen R, Hornick Matthew, Sigalova Maryana, Kang Harriet, Moshé Solomon L
Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Pediatr Neurol. 2005 Sep;33(3):166-72. doi: 10.1016/j.pediatrneurol.2005.03.005.
This study assessed the utility of rectal diazepam gel in the home management of prolonged or repetitive seizures in children. Thirty-eight children being prescribed rectal diazepam gel by their clinician were prospectively recruited. Seizures, rectal diazepam use, emergency department visits, and quality of life data before and after study entry were recorded. The 38 children included 14 (37%) with complex febrile seizures, and 24 with epilepsy (n = 22) or a single seizure (n = 2). There were 23 (61%) children with prolonged seizures and 15 (39%) with repetitive seizures. During the 6-month follow-up period, 12 children experienced 26 seizures which met the criteria for rectal diazepam administration. Rectal diazepam gel was administered to 8 children on 19 occasions. In 16 (84%) of these episodes, seizures stopped and no emergency department visit was required. Parental stress was decreased between baseline and 6 months in both the overall group and in all the subgroups. Home use of rectal diazepam gel is effective in aborting seizure activity, often avoiding an emergency department visit. Its use reduces morbidity and costs associated with hospital visits and provides parents a treatment option for home management of prolonged or repetitive seizures.
本研究评估了直肠用地西泮凝胶在儿童长时间或反复癫痫发作家庭管理中的效用。前瞻性招募了38名由临床医生开具直肠用地西泮凝胶处方的儿童。记录了研究入组前后的癫痫发作情况、直肠用地西泮的使用情况、急诊就诊情况以及生活质量数据。这38名儿童中，14名（37%）患有复杂性热性惊厥，24名患有癫痫（n = 22）或单次癫痫发作（n = 2）。有23名（61%）儿童出现长时间癫痫发作，15名（39%）出现反复癫痫发作。在6个月的随访期内，12名儿童经历了26次符合直肠用地西泮给药标准的癫痫发作。直肠用地西泮凝胶共对8名儿童使用了19次。在这些发作中，16次（84%）癫痫发作停止，无需急诊就诊。总体组以及所有亚组中，家长的压力在基线和6个月时均有所降低。在家中使用直肠用地西泮凝胶可有效终止癫痫发作活动，常常避免急诊就诊。其使用可降低与医院就诊相关的发病率和费用，并为家长提供了一种在家中管理长时间或反复癫痫发作的治疗选择。
