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Rectal diazepam (RD) is the most commonly prescribed medication for home rescue treatment of seizures, but it is awkward to administer, is expensive, and has a short half-life. A less expensive alternative — midazolam — is available in an intranasal form that rapidly crosses the nasal mucosa into the cerebrospinal fluid. Previous studies have shown that intranasal midazolam (IM) is as effective as RD for treatment of seizures in the emergency department, with more-rapid onset of action and possibly fewer adverse effects.
In a randomized study, researchers compared the use of RD and IM for home treatment of seizures in 92 patients (age, <18 years) with known seizure disorders; 50 patients received a prescription for IM (0.2 mg/kg; maximum dos…