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A Comparison of Rectal Diazepam Gell and Placebo for Acute Repetitive Seizures NEJM 338:1869-1875, 19161998., Dreifuss,F.E.,et al, 1998 See this aricle in Pubmed Article Abstract Of 125 study patients(64 assigned to diazepam and 61 to placebo)with a history of acute repetitive seizures,91(47 children and 44 adults)were treated for an exacerbation of seizures during the study period.Diazepam treatment was superior to placebo with regard to the outcome variables related to efficacy:reduced seizure frequency(P<0.001)and improved global assessment of treatment outcome by the care giver(frequency and severity of seizures and drug toxicity)(P<0.001).Post hoc analysis showed diazepam to be superior to placebo in reducing seizure frequency in both children (P<0.001)and adults(P=0.02),but only in children was it superior with regard to improvement in global outcome(P<0.001).The time to the first recurrence of seizures after initial treatment was longer for the patients receiving diazepam(P<0.001).thirty-five patients reported at least one adverse effect of treatment;somnolence was the most frequent.Respiratory depression was not reported.Rectal diazepam gel,administered at home by trained care givers,is an effective and well-tolerated treatment for acute repetitive seizures.

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