Midazolam jako lek ratunkowy w napadach padaczkowych w domu i na oddziale szpitalnym Artykuł przeglądowy
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Opublikowane:
mar 1, 2026
Słowa kluczowe:
midazolam dopoliczkowy, benzodiazepiny, napady padaczkowe
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Abstrakt
Midazolam dopoliczkowy jest skutecznym i bezpiecznym lekiem ratunkowym stosowanym w przerywaniu napadów padaczkowych w warunkach domowych oraz w leczeniu przedszpitalnym. Szybka interwencja ma kluczowe znaczenie w zapobieganiu rozwojowi stanu padaczkowego. Skuteczność midazolamu jest porównywalna z innymi benzodiazepinami, a dzięki łatwej drodze podania i dobrej biodostępności lek ten stanowi preparat pierwszego wyboru.
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Jak cytować
Kurkowska-Jastrzębska, I. (2026). Midazolam jako lek ratunkowy w napadach padaczkowych w domu i na oddziale szpitalnym . Medycyna Faktów , 19(4(69), 506-512. https://doi.org/10.24292/01.MF.0425.04
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Artykuły
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Bibliografia
1. Charakterystyka Produktu Leczniczego. Midazolam.
2. Peter JU, Dieudonné P, Zolk O. Pharmacokinetics, Pharmacodynamics, and Side Effects of Midazolam: A Review and Case Example. Pharmaceuticals (Basel). 2024; 17(4): 473. http://doi.org/10.3390/ph17040473.
3. Silbergleit R, Durkalski V, Lowenstein D et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med. 2012; 366(7): 591-600. http://doi.org/10.1056/NEJMoa1107494.
4. Mazurkiewicz-Bełdzińska M, Szmuda M, Zawadzka M et al. Current treatment of convulsive status epilepticus – a therapeutic protocol and review. Anaesthesiol Intensive Ther. 2014; 46: 293-300.
5. Public Assessment Report. Scientific discussion Nasolam 2.5 mg, 3.75 mg and 5 mg nasal spray, solution in single-dose container (midazolam hydrochloride).
6. bbMullhi R, Hayton T, Midgley-Hunt A et al. Guidance for: The acute management of status epilepticus in adult patients. J Intensive Care Soc. 2025; 26(2): 249-62. http://doi.org/10.1177/17511437251321338.
7. Carreño M, Kim-Wisskirchen IH, Forcadell Ferré M et al. Midazolam Oromucosal Solution for the Management of Prolonged Convulsive Seizures in Adult Outpatients: Addressing Unmet Needs in Europe. Clin Drug Investig. 2025; 45(12): 923-33. http://doi.org/10.1007/s40261-025-01493-0.
8. Ma Y, Lu C, Hastie P et al. Medications used for seizure-emergency management in the UK community: A clinical practice research datalink retrospective database study. Epilepsia Open. 2025; 10(4): 1023-33. http://doi.org/10.1002/epi4.70035.
9. Chin RF, Neville BG, Peckham C et al.; NLSTEPSS Collaborative Group. Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. Lancet. 2006; 368(9531): 222-29.
10. Osborne A, Taylor L, Reuber M et al. Pre-hospital care after a seizure: evidence base and United Kingdom management guidelines. Seizure. 2015; 24: 82-7.
11. Pina-Garza JE, Chez M, Cloyd J et al. Outpatient management of prolonged seizures and seizure clusters to prevent progression to a higher-level emergency: Consensus recommendations of an expert working group. Epileptic Disord. 2024; 26(4): 484-97.
12. Jafarpour S, Pisani F, Neshagh H et al. Seizure clusters: definition, prevalence, consequences and acute management. Seizure. 2018; 68: 9-15.
13. Asadi-Pooya AA, Nei M, Sharan A et al. Seizure clusters in drug-resistant focal epilepsy. Epilepsia. 2016; 57(9): e187-90. http://doi.org/10.1111/epi.13465.
14. Detyniecki K, O’Bryan J, Choezom T et al. Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy. Epilepsy Behav. 2018; 88: 349-56. http://doi.org/10.1016/j.yebeh.2018.09.035.
15. Jafarpour S, Fong MWK, Detyniecki K et al. Prevalence and Predictors of Seizure Clusters in Pediatric Patients With Epilepsy: The Harvard-Yale Pediatric Seizure Cluster Study. Pediatr Neurol. 2022; 137: 22-9. http://doi.org/10.1016/j.pediatrneurol.2022.08.014.
16. Bauman K, Kao A, Penovich P et al. Rescue therapies for seizure clusters: a review of intranasal benzodiazepines and other options. Front Neurol. 2021; 12: 636045.
17. Sillanpää M, Schmidt D. Long-term outcome of childhood-onset epilepsy: a prospective population-based study. Brain. 2008; 131(Pt 4): 938-94.
18. Trinka E, Cock H, Hesdorffer D et al. A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015; 56(10): 1515-23.
19. Pallin DJ, Goldstein JN, Moussally JS et al. Seizure visits in US emergency departments: epidemiology and potential disparities in care. Int J Emerg Med. 2008; 1: 97-105. https://doi.org/10.1007/s12245-008-0024-4.
20. Dobesberger J, Ristić AJ, Walser G et al. Duration of focal complex, secondarily generalized tonic-clonic, and primarily generalized tonic-clonic seizures – A video-EEG analysis. Epilepsy Behav. 2015; 49: 111-7. https://doi.org/10.1016/j.yebeh.2015.03.023.
21. Beljemann JP. Status epilepticus in adults. Lancet Neurol. 2015; 14: 615-24.
22. Knake S, Hamer HM, Rosenow F. Status epilepticus: a critical review. Epilepsy Behav. 2009; 15(1): 10-4. https://doi.org/10.1016/j.yebeh.2009.02.027.
23. Naylor DE. Mechanisms of seizure termination and implications for treatment of status epilepticus. Epileptic Disord. 2014; 16(Suppl 2): S69-S83.
24. Becker DA, Sarma D, Gidal BE et al. Rescue medication strategies for seizure clusters: a review and clinical perspective. Neurol Ther. 2023; 12: 1439-55.
25. Gainza-Lein M, Hameed B, Saxena S et al. Efficacy of early treatment in status epilepticus and seizure clusters. JAMA Neurol. 2018; 75: 410-8.
26. Heuser K, Olsen KB, Ulvin LB et al. Chapter 5.Modern Treatment of Status Epilepticus in Adults. In: Epilepsy. Czuczwar SJ (ed.). Exon Publications, Brisbane (AU) 2022.
27. Cruickshank M, Imamura M, Counsell C et al. Management of the first stage of convulsive status epilepticus in adults: a systematic review of current randomised evidence. J Neurol. 2022; 269(7): 3420-9. http://doi.org/10.1007/s00415-022-10979-2.
28. McIntyre J, Robertson S, Norris E et al. Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: a randomised controlled trial. Lancet. 2005; 366(9481): 205-10. http://doi.org/10.1016/S0140-6736(05)66909-7.
29. McMullan J, Sasson C, Pancioli A et al. Midazolam versus diazepam for the treatment of status epilepticus in children and young adults: a meta-analysis. Acad Emerg Med. 2010; 17(6): 575-82. http://doi.org/10.1111/j.1553-2712.2010.00751.x.
30. Brigo F, Nardone R, Tezzon F et al. Nonintravenous midazolam versus intravenous or rectal diazepam for the treatment of early status epilepticus: A systematic review with meta-analysis. Epilepsy Behav. 2015; 49: 325-36. http://doi.org/10.1016/j.yebeh.2015.02.030.
31. Möller L, Fisch U, Habermehl L et al. Treating status epilepticus in clinical practice-a multi-national survey in Germany, Austria, and Switzerland. Front Neurol. 2025; 16: 1685993. http://doi.org/10.3389/fneur.2025.1685993.
32. Alldredge BK, Gelb AM, Isaacs SM et al. A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med. 2001; 345(9): 631-7.
2. Peter JU, Dieudonné P, Zolk O. Pharmacokinetics, Pharmacodynamics, and Side Effects of Midazolam: A Review and Case Example. Pharmaceuticals (Basel). 2024; 17(4): 473. http://doi.org/10.3390/ph17040473.
3. Silbergleit R, Durkalski V, Lowenstein D et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med. 2012; 366(7): 591-600. http://doi.org/10.1056/NEJMoa1107494.
4. Mazurkiewicz-Bełdzińska M, Szmuda M, Zawadzka M et al. Current treatment of convulsive status epilepticus – a therapeutic protocol and review. Anaesthesiol Intensive Ther. 2014; 46: 293-300.
5. Public Assessment Report. Scientific discussion Nasolam 2.5 mg, 3.75 mg and 5 mg nasal spray, solution in single-dose container (midazolam hydrochloride).
6. bbMullhi R, Hayton T, Midgley-Hunt A et al. Guidance for: The acute management of status epilepticus in adult patients. J Intensive Care Soc. 2025; 26(2): 249-62. http://doi.org/10.1177/17511437251321338.
7. Carreño M, Kim-Wisskirchen IH, Forcadell Ferré M et al. Midazolam Oromucosal Solution for the Management of Prolonged Convulsive Seizures in Adult Outpatients: Addressing Unmet Needs in Europe. Clin Drug Investig. 2025; 45(12): 923-33. http://doi.org/10.1007/s40261-025-01493-0.
8. Ma Y, Lu C, Hastie P et al. Medications used for seizure-emergency management in the UK community: A clinical practice research datalink retrospective database study. Epilepsia Open. 2025; 10(4): 1023-33. http://doi.org/10.1002/epi4.70035.
9. Chin RF, Neville BG, Peckham C et al.; NLSTEPSS Collaborative Group. Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. Lancet. 2006; 368(9531): 222-29.
10. Osborne A, Taylor L, Reuber M et al. Pre-hospital care after a seizure: evidence base and United Kingdom management guidelines. Seizure. 2015; 24: 82-7.
11. Pina-Garza JE, Chez M, Cloyd J et al. Outpatient management of prolonged seizures and seizure clusters to prevent progression to a higher-level emergency: Consensus recommendations of an expert working group. Epileptic Disord. 2024; 26(4): 484-97.
12. Jafarpour S, Pisani F, Neshagh H et al. Seizure clusters: definition, prevalence, consequences and acute management. Seizure. 2018; 68: 9-15.
13. Asadi-Pooya AA, Nei M, Sharan A et al. Seizure clusters in drug-resistant focal epilepsy. Epilepsia. 2016; 57(9): e187-90. http://doi.org/10.1111/epi.13465.
14. Detyniecki K, O’Bryan J, Choezom T et al. Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy. Epilepsy Behav. 2018; 88: 349-56. http://doi.org/10.1016/j.yebeh.2018.09.035.
15. Jafarpour S, Fong MWK, Detyniecki K et al. Prevalence and Predictors of Seizure Clusters in Pediatric Patients With Epilepsy: The Harvard-Yale Pediatric Seizure Cluster Study. Pediatr Neurol. 2022; 137: 22-9. http://doi.org/10.1016/j.pediatrneurol.2022.08.014.
16. Bauman K, Kao A, Penovich P et al. Rescue therapies for seizure clusters: a review of intranasal benzodiazepines and other options. Front Neurol. 2021; 12: 636045.
17. Sillanpää M, Schmidt D. Long-term outcome of childhood-onset epilepsy: a prospective population-based study. Brain. 2008; 131(Pt 4): 938-94.
18. Trinka E, Cock H, Hesdorffer D et al. A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015; 56(10): 1515-23.
19. Pallin DJ, Goldstein JN, Moussally JS et al. Seizure visits in US emergency departments: epidemiology and potential disparities in care. Int J Emerg Med. 2008; 1: 97-105. https://doi.org/10.1007/s12245-008-0024-4.
20. Dobesberger J, Ristić AJ, Walser G et al. Duration of focal complex, secondarily generalized tonic-clonic, and primarily generalized tonic-clonic seizures – A video-EEG analysis. Epilepsy Behav. 2015; 49: 111-7. https://doi.org/10.1016/j.yebeh.2015.03.023.
21. Beljemann JP. Status epilepticus in adults. Lancet Neurol. 2015; 14: 615-24.
22. Knake S, Hamer HM, Rosenow F. Status epilepticus: a critical review. Epilepsy Behav. 2009; 15(1): 10-4. https://doi.org/10.1016/j.yebeh.2009.02.027.
23. Naylor DE. Mechanisms of seizure termination and implications for treatment of status epilepticus. Epileptic Disord. 2014; 16(Suppl 2): S69-S83.
24. Becker DA, Sarma D, Gidal BE et al. Rescue medication strategies for seizure clusters: a review and clinical perspective. Neurol Ther. 2023; 12: 1439-55.
25. Gainza-Lein M, Hameed B, Saxena S et al. Efficacy of early treatment in status epilepticus and seizure clusters. JAMA Neurol. 2018; 75: 410-8.
26. Heuser K, Olsen KB, Ulvin LB et al. Chapter 5.Modern Treatment of Status Epilepticus in Adults. In: Epilepsy. Czuczwar SJ (ed.). Exon Publications, Brisbane (AU) 2022.
27. Cruickshank M, Imamura M, Counsell C et al. Management of the first stage of convulsive status epilepticus in adults: a systematic review of current randomised evidence. J Neurol. 2022; 269(7): 3420-9. http://doi.org/10.1007/s00415-022-10979-2.
28. McIntyre J, Robertson S, Norris E et al. Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: a randomised controlled trial. Lancet. 2005; 366(9481): 205-10. http://doi.org/10.1016/S0140-6736(05)66909-7.
29. McMullan J, Sasson C, Pancioli A et al. Midazolam versus diazepam for the treatment of status epilepticus in children and young adults: a meta-analysis. Acad Emerg Med. 2010; 17(6): 575-82. http://doi.org/10.1111/j.1553-2712.2010.00751.x.
30. Brigo F, Nardone R, Tezzon F et al. Nonintravenous midazolam versus intravenous or rectal diazepam for the treatment of early status epilepticus: A systematic review with meta-analysis. Epilepsy Behav. 2015; 49: 325-36. http://doi.org/10.1016/j.yebeh.2015.02.030.
31. Möller L, Fisch U, Habermehl L et al. Treating status epilepticus in clinical practice-a multi-national survey in Germany, Austria, and Switzerland. Front Neurol. 2025; 16: 1685993. http://doi.org/10.3389/fneur.2025.1685993.
32. Alldredge BK, Gelb AM, Isaacs SM et al. A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med. 2001; 345(9): 631-7.