Home Treatment for Prolonged or Clustering Seizures: Benzodiazepines

Benzodiazepines are a class of medicines used to treat prolonged or clustering seizures. They stop seizures immediately by slowing down the central nervous system.

These medicines are often known by their brand names. For example, midazolam is also known as Versed, the manufacturer’s brand name. Benzodiazepines that children use to control prolonged or cluster seizers include:

• Lorazepam (Ativan, Lorazepam Intensol).
• Midazolam (Versed).
• Diazepam (Valium, Diastat, Lorazepam Intensol).

Your neurologist will decide how to give your child the medicine. This often depends on how quickly the medicine must work, whether your child is alert enough to swallow, and if your child drools heavily during seizures. There are three different ways to give medicines:

• Buccal: In the pocket between your child’s cheek and gums.
• Intranasal: Inside your child’s nostrils.
• Rectal: Inside your child’s rectum.

No matter which method you use, always give the medicine:

• Exactly as instructed.
• Only when needed.

Benzodiazepines will make children drowsy, dizzy, or less alert than normal. Rarely, children might become hyperactive or irritable (grumpy) for some time. The most common side effects include:

• Nasal irritation.
• Bad taste.
• Cooling or burning sensation in nose or throat.

Most of the following side effects are not common, but if they occur, they might be a sign of a serious problem. Call your child’s neurologist immediately or take your child to the emergency room if your child has any of these side effects: 

• Trouble breathing.
• Severe weakness.
• Seizures that don’t stop.

The best way to store medicine depends on what it’s made of. 

• Lorazepam Intensol: Refrigerate once the vial is opened.
• Diazepam rectal gel (Diastat): Keep at room temperature, out of extreme hot or cold temperatures.
• Midazolam: Protect from light by storing in a brown paper bag or amber-colored bag. Keep midazolam out of extreme hot or cold temperatures. 

Whichever medicine your child uses:

• Never leave it in a car, where temperatures can become too hot or too cold.
• Don’t keep any medicine that’s out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines. 
• Keep it out of the sight and reach of children, locked up in a safe place. If a child takes an overdose of this medicine, it’s a medical emergency.

Because benzodiazepines might cause dizziness or drowsiness, they might impair your child’s ability to make good decisions. Watch carefully when your child needs to be alert for an activity, such as climbing stairs.

• DON’T share medicine with others.
• DO keep a list of all medicines, which you can share with your pharmacist and all health care providers.
• DO call your pharmacy at least two days before medicine runs out, so you have time to order refills. Always have enough emergency seizure medicine on hand in case your child needs it.

Talk to your Gillette neurology nurse or contact Telehealth Nursing at 651-229-3890.