What do systematic reviews say?

Summary of findings ‐ Intravenous lorazepam vs intravenous diazepam/intravenous phenytoin combination

Summary of findings ‐ Intravenous lorazepam showed no clear difference in incidence of respiratory depression compared with intravenous diazepam/intravenous phenytoin combination (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.78 [0.22, 2.82]
  1 study · 178 participants
  Moderate

Summary of findings ‐ Intravenous lorazepam vs intravenous diazepam/intravenous phenytoin combination

Summary of findings ‐ Intravenous lorazepam showed no clear difference in additional drugs required to stop the seizure compared with intravenous diazepam/intravenous phenytoin combination (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.42 [0.17, 1.04]
  1 study · 178 participants
  Moderate

Summary of findings ‐ Intravenous lorazepam vs intravenous diazepam/intravenous phenytoin combination

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 178 participants
  Moderate

Summary of findings ‐ Intravenous lorazepam vs intravenous diazepam/intravenous phenytoin combination

The review found no eligible studies for this question.

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Benzodiazepines (lorazepam) vs diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 80 participants
  Moderate

Summary of findings ‐ Buccal midazolam vs rectal diazepam

It is very uncertain whether summary of findings ‐ Buccal midazolam changes seizure cessation: within 5 minutes to 1 hour compared with rectal diazepam (very low certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 1.25 [1.13, 1.38]
  4 studies · 648 participants
  Very low

Summary of findings ‐ Buccal midazolam vs rectal diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 141 participants
  Low

Summary of findings ‐ Buccal midazolam vs rectal diazepam

Summary of findings ‐ Buccal midazolam showed no clear difference in incidence of respiratory depression compared with rectal diazepam (low certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.88 [0.61, 1.25]
  4 studies · 648 participants
  Low

Summary of findings ‐ Buccal midazolam vs rectal diazepam

Summary of findings ‐ Buccal midazolam may leads to lower additional drugs required to stop the seizure: intravenous lorazepam… compared with rectal diazepam (low certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.58 [0.42, 0.79]
  1 study · 177 participants
  Low

Summary of findings ‐ Buccal midazolam vs rectal diazepam

The review found no eligible studies for this question.

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Benzodiazepines (lorazepam) vs diazepam

Summary of findings ‐ Lorazepam probably leads to lower incidence of respiratory depression compared with diazepam (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.72 [0.55, 0.93]
  3 studies · 439 participants
  Moderate

Summary of findings ‐ Buccal midazolam vs rectal diazepam

The review found no eligible studies for this question.

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings ‐ Buccal midazolam vs intravenous diazepam

Summary of findings ‐ Buccal midazolam showed no clear difference in seizure cessation compared with intravenous diazepam (high certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.91 [0.8, 1.03]
  1 study · 120 participants
  High

Summary of findings ‐ Buccal midazolam vs intravenous diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 120 participants
  Moderate

Summary of findings ‐ Buccal midazolam vs intravenous diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 120 participants
  High

Summary of findings ‐ Buccal midazolam vs intravenous diazepam

The review found no eligible studies for this question.

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings ‐ Buccal midazolam vs intravenous diazepam

The review found no eligible studies for this question.

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings ‐ Buccal midazolam vs intravenous diazepam

The review found no eligible studies for this question.

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings ‐ Intranasal midazolam vs intravenous diazepam

Summary of findings ‐ Intranasal midazolam showed no clear difference in seizure cessation compared with intravenous diazepam (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.98 [0.91, 1.06]
  2 studies · 122 participants
  Moderate

Summary of findings ‐ Intranasal midazolam vs intravenous diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 122 participants
  Moderate