Febrile infection-related epilepsy syndrome treated successfully with enteral lorazepam as a substitute for intravenous midazolam as weaning drug

• Main Authors: Amarlok Kumar, Ravi Sharma, Preeti Kharwas, Anupam Chaturvedi, Vivek Jain
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Journal of Pediatric Critical Care
• Subjects: enteral lorazepam; febrile infection-related epilepsy syndrome; successful; treatment
• Online Access: http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2021;volume=8;issue=1;spage=39;epage=41;aulast=Kumar
• ISSN: 2349-6592; 2455-7099

Febrile infection-related epilepsy syndrome (FIRES) is an acute-onset epilepsy syndrome usually refractory to conventional antiepileptics and immunomodulation. Here, we report an adolescent male child whose seizures were refractory to multiple anticonvulsants, high-dose phenobarbitone, and ketogenic diet. He subsequently responded to coma induction with midazolam, though with seizure recurrences following multiple attempts at weaning of midazolam over the next 2½ months. Due to continuing prolonged intensive care stay, we substituted intravenous midazolam for equivalent dose of enteral lorazepam with good seizure control.