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Clonazepam in Children Status Epilepticus

Completed
Conditions
Epilepticus Status
Interventions
Other: Efficacy of intravenous clonazepam
Registration Number
NCT04287361
Lead Sponsor
University Hospital, Montpellier
Brief Summary

•Background: Intravenous clonazepam is the most widely used first-line benzodiazepine in Europe for the initial management of status epilepticus in children.

The guidelines of the "Société de reanimation de langue francaise" (SRLF) and the "société française de médecine d'urgence" (SFMU) published in 2018 recommend an initial loading dose of 0.015 mg / kg of clonazepam in this situation (maximum 1.5 mg).

To our knowledge, there is no specific study of the efficacy of clonazepam according to the dose used.

Objective: To compare the effectiveness of the initial loading dose of clonazepam in children treated for status epilepticus

•Methods: Monocentric retrospective study including children \< 16 years who have benefited from an initial loading dose of clonazepam in the context of status epilepticus treated at the Montpellier University Hospital between January 2016 and June 2019.

The investigators collected data from medical records (clinic, treatment , evolution) and compared these according to the dosage of clonazepam used.

•Discussion: Among the benzodiazepines used in the first-line treatment of pediatric status epileptic, lorazepam and midazolam are the most widely used drugs in the world.

Lorazepam is not so much used in Europe because the injectable form is not available for a daily use. Conversely, clonazepam is used in a large number of European countries but is rarely used in the United States due to the lack of an injectable form.

About the tolerance of treatment, except overdose situations, clonazepam is a drug well tolerated in the pediatric populatin. The main side effects of clonazepam are respiratory depression and impaired alertness.

To our knowledge, this study is the first to examine the efficacy depending on the initial loading dosage of clonazepam in children status epilepticus.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
310
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Loading dose ≥ 0,03 mg/kgEfficacy of intravenous clonazepamPatient being treated for a status epilepticus who received an initial dose of clonazepam ≥ 0.03 mg / kg
Loading dose < 0,03 mg/kgEfficacy of intravenous clonazepamPatient being treated for a status epilepticus who received an initial dose of clonazepam \< 0.03 mg / kg
Primary Outcome Measures
NameTimeMethod
effectiveness in stopping seizures1 day

The primary endpoint was clinical cessation of seizures, which was defined as the absence of clinical signs of seizures immediately following the injection of clonazepam.

Secondary Outcome Measures
NameTimeMethod
duration of seizure1 day

duration of seizure (minutes)

type of seizures1 day

type of seizures (focal, generalized);

whether or not to use a dose greater than one milligram1 day

whether or not to use a dose greater than one milligram

aetiologies ;1 day

aetiologies (idiopathic, symptomatic)

using another antiepileptic drug1 day

using another antiepileptic drug (phenobarbital, fosphenytoin, thiopental)

Hospitalization in an intensive care or resuscitation unit1 day

Hospitalization in an intensive care or resuscitation unit

need for a second dose of clonazepam1 day

need for a second dose of clonazepam

pre-hospital treatment used1 day

pre-hospital treatment used

introduction of a maintenance dose1 day

introduction of a maintenance dose

Rate of hospitalization in conventional sector1 day

Rate of hospitalization in conventional sector

introduction of antiepileptic treatment after treatment1 day

introduction of antiepileptic treatment after treatment

Trial Locations

Locations (1)

Uh Montpellier

🇫🇷

Montpellier, France

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