Comparing Evidence-Based Emergency Interventions for Seizure Management in the Pediatric Populatin

Epilepsy affects approximately 470,000 children nation wide. Some of the emergency treatments of an epileptic episode include: rectal diazepam, intranasal midazolam, and vagus nerve stimulation. It is essential to evaluate and research the most effective, cost effective, and accessible treatments in order to provide pediatric patients with optimum quality of life and caregivers with ease of treatment interventions. The purpose of this literature review was to compare evidence-based emergency seizure interventions in children with epilepsy. Evidence reviewed assessed the efficacy, accessibility, and user friendliness of rectal diazepam, intranasal midazolam, and vagus nerve stimulation as emergency seizure interventions. This literature review was performed using the John Hopkins nursing evidence-based practice model. The articles found were ranked using the JHNEBP Evidence Rating Scale. When comparing intranasal midazolam and rectal diazepam, the evidence points to intranasal midazolam being the more effective seizure management intervention based on its efficacy, accessibility, and user friendliness. However, vagus nerve stimulation is an option that is becoming more readily accessible and has proven its efficacy in seizure cessation in the pediatric population. Although all three interventions will succeed in seizure cessation, the long-term effects, benefits, and costs should be considered when treating pediatric epilepsy.

Key words: pediatrics, epilepsy, intranasal midazolam, rectal diazepam, vagus nerve stimulator