Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions, also called a seizure disorder. A seizure lasting longer than five minutes is a medical emergency and needs always to be treated. The main threat is that a status epilepticus (SE) may develop, which is a state of persistent seizures, which is potentially lethal. In advance, it is not known when a seizure will occur, nor how long it will last and if it will develop into a dangerous SE. For most, if not all epileptics, this is very worrisome and causes a constant feeling of stress.
Currently there is no cure for epilepsy. It can only be treated through the use of anti-epileptic drugs (AEDs) that prevent the recurrence of seizures. In 60-70% of the patients, using AED’s, seizure control will be established. However, in the remainder 30-40%, seizure control cannot be achieved, and this group will still experience seizures.
Midazolam is the best compound to stop an epileptic seizure, due to its fast onset of action and limited duration. Although not approved anywhere in the world for the treatment of epileptic seizures, its use as such is widely accepted and described in numerous compendia, textbooks and in standard operating procedures for neurologists. The Authorities allow the use for this indication, as it is the most effective available drug in seizure management. This compound however should be administered as an intravenous injection.
Alternatively a rectal formulation containing diazepam could be administered but this route comes with physical and social constraints, and the onset of action of diazepam is (too) slow and its effect lasts (too) long.
Midazolam nasal spray can be administered by everyone and thus will save valuable time (no need to wait for a MD/well trained nurse) and will potentially save lives. And, above all it will increase the quality of life of all epileptics (and their close ones) as they are assured to have access all the time to the best possible drug.