Abstracts

Diazepam rectal gel (Diastat[reg]) is approved by the United States Food and Drug Administration for the treatment of acute repetitive seizures. The medication can be administered by nonmedical caregivers with appropriate training. Use of diazepam rectal gel could help patients avoid visits to the emergency department (ED). This study evaluates the use of diazepam rectal gel in mentally retarded patients with intractable epilepsy.
In this retrospective study, the charts of 37 severely mentally retarded patients with intractable multifocal symptomatic epilepsy syndrome from Erie Homes for Children and Adults were evaluated. The frequency of ED visits was assessed during the baseline period (March 1999 through February 2001) and during the period of diazepam rectal gel use (March 2001 through March 2003). The number of patients receiving diazepam rectal gel and the number of doses received were counted.
Mean patient age was 29.1 years (range=12 to 54 years). During the baseline period, 5 patients visited the ED for intractable seizures (1 visit each patient). During the period of diazepam rectal gel use, 21 patients received diazepam rectal gel (mean number of doses=12.8, range=1 to 110), and only 2 patients visited the ED. One of these patients visited the ED after 3 diazepam rectal gel doses failed to stop seizing. The other patient visited the ED after a long period of unresponsiveness that was not immediately recognized as a seizure as it was not the patient[rsquo]s typical seizure presentation. This patient[rsquo]s seizure resolved without treatment in the ED. No adverse events were reported with diazepam rectal gel use.
The results suggest that diazepam rectal gel was effective in controlling seizures in these patients, and the use of diazepam rectal gel could help patients avoid ED visits. Since diazepam rectal gel became available, caregivers at the Erie Homes for Children and Adults have reported increased confidence during seizure emergencies, reduced stress, and a decreased need to call for medical assistance.