What do systematic reviews say?

Summary of findings ‐ Intranasal 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 ‐ Intramuscular midazolam vs intravenous diazepam

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

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.97 [0.87, 1.09]
  2 studies · 105 participants
  Low

Benzodiazepines (lorazepam) vs diazepam

Summary of findings ‐ Lorazepam showed no clear difference in seizure recurrence within 24 hours compared with diazepam (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.86 [0.61, 1.2]
  3 studies · 439 participants
  Moderate

Summary of findings ‐ Intramuscular 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 · 105 participants
  Very low

Summary of findings ‐ Intramuscular 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 · 105 participants
  Low

Summary of findings ‐ Intramuscular midazolam vs intravenous diazepam

It is very uncertain whether summary of findings ‐ Intramuscular midazolam changes additional drugs required to terminate the seizure compared with intravenous diazepam (very low certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 1.34 [0.35, 5.13]
  2 studies · 105 participants
  Very low

Summary of findings ‐ Intramuscular midazolam vs intravenous diazepam

It is very uncertain whether summary of findings ‐ Intramuscular midazolam changes seizure recurrence within 24 hours: within one hour compared with intravenous diazepam (very low certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.85 [0.27, 2.62]
  1 study · 24 participants
  Very low

Summary of findings ‐ Intramuscular 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 · 81 participants
  Moderate

Summary of findings ‐ Intramuscular midazolam vs rectal diazepam

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

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 1.02 [0.93, 1.12]
  1 study · 100 participants
  Moderate

Summary of findings ‐ Intramuscular 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
  1 study · 100 participants
  Moderate

Summary of findings ‐ Intramuscular 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
  1 study · 100 participants
  Moderate

Summary of findings ‐ Intramuscular 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 ‐ Intramuscular 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
  1 study · 100 participants
  Moderate

Benzodiazepines (lorazepam) vs diazepam

Summary of findings ‐ Lorazepam may leads to lower incidence of admissions to the ICU compared with diazepam (low certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.15 [0.02, 0.98]
  1 study · 86 participants
  Low

Summary of findings ‐ Intramuscular 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

Intravenous midazolam vs intravenous diazepam

Summary of findings ‐ Intravenous 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 1.08 [0.97, 1.21]
  1 study · 80 participants
  Moderate

Intravenous 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 · 80 participants
  Moderate

Intravenous midazolam vs intravenous diazepam

Summary of findings ‐ Intravenous midazolam showed no clear difference in incidence of respiratory depression 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 0.33 [0.01, 7.95]
  1 study · 80 participants
  Moderate

Intravenous midazolam vs intravenous diazepam

Summary of findings ‐ Intravenous midazolam showed no clear difference in additional drugs required to stop the seizure: additional dose of… 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 0.25 [0.03, 2.14]
  1 study · 80 participants
  Moderate

Intravenous midazolam vs intravenous diazepam

Summary of findings ‐ Intravenous midazolam showed no clear difference in seizure recurrence within 24 hours 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 0.5 [0.1, 2.58]
  1 study · 80 participants
  Moderate