Abstracts

RATIONALE: Rectal Valium (Diastat) is approved for treating acute seizures and shows good efficacy in pre-approval clinical trials. The purpose of the current study was to examine the use and efficacy of Diastat in the actual clinical practice of an epilepsy monitoring unit.
METHODS: A retrospective chart review was performed to identify all patients (index cases) for whom Diastat was ordered or used in an inpatient epilepsy monitoring unit. A random sample (of equal size to the index cases) of patients who required treatment for status or acute seizures and who received lorazepam were chosen as control cases. Index vs. control cases were compared for seizure demographics (age and age at seizure onset) and response to treatment (seizure duration before AED administration, time to seizure cessation after AED administration, side effects).
RESULTS: Forty-six patients had Diastat ordered, of whom 23 received it for acute seizures. Fifty-seven patients had lorazepam ordered, of whom 23 received it. There were no significant differences in age or age at onset between patients who did vs. did not receive Diastat and those who did vs. did not receive lorazepam. There were no significant differences between patients receiving Diastat vs. lorazepam for duration of the acute seizure prior to treatment, time from administration to seizure cessation, or side effects post-treatment. However, patients receiving Diastat were younger (23.9y vs. 34.5y, p[lt].05) and had an earlier age at seizure onset (5.2y vs. 15.1y, p[lt].05) than patients receiving lorazepam. More patients with generalized seizures received Diastat while more patients with partial seizures received lorazepam (p[lt].04).
CONCLUSIONS: Diastat can be effectively used on an epilepsy monitoring unit. It results in effective seizure cessation with few side effects.
Support: This research was funded in part by a grant from Elan Pharmaceuticals.
Disclosure: Grant - Elan Pharmaceuticals