Abstracts

RATIONALE: DZPRG (Diastat(r)) is approved for patients >2 years with epilepsy who experience breakthrough seizures (clusters) despite treatment with antiepileptic drugs (AEDs). It is not approved for use <2 years or for FS. Other forms of rectal diazepam are commonly used for complicated FS in Europe and Asia. METHODS: : We reviewed our experience using DZPRG (Diastat?) for children with epilepsy ?2 years, and for FS. Outpatient notes between November 1997 and March 2000 were searched. Age, indications, dosage, other AEDs, and results of treatment were abstracted. Parents of children with FS, generally seen for consultation only, were telephoned to obtain followup information. RESULTS: Fourteen infants with intractable epilepsy under age 2 years received DZPRG for breakthrough seizures. Dosage ranged from 2.5-10mg (.24-.6mg/kg). Most used DZPRG on multiple occasions, with variable success in terminating clusters or prolonged seizures, without significant adverse events. Eleven infants (ages .9-3 years) had DZPRG prescribed for complicated, multiple or prolonged FS. Dosage was 5mg (.4-.65 mg/kg). None were taking chronic AEDs when DZPRG was prescribed, but one later started taking phenobarbital due to frequent FS. Parents were contacted by telephone. Most had not yet used DZPRG, but continue to keep it on hand. Two reported they had used DZPRG to successfully stop a febrile seizure or cluster, one on multiple occasions. CONCLUSIONS:_DZPRG (Diastat(r)) can be safely used for selected infants <2 years with severe epilepsy. Availability of DZPRG may be reassuring to parents of children with complicated FS, even if it is used infrequently.