Case Series of Midazolam-Induced Seizures-Like Activity in Five Neonates

Abstract

An intravenous administration of midazolam may result in seizure-like activity or movement. This report describes five neonates who developed seizure-like movements after intravenous midazolam injection. The patients presented between 2019 and 2022. The abnormal movements occurred shortly after intravenous bolus administration of midazolam. None of our patients experienced seizure-like movements after receiving midazolam infusions. The seizure-like movements were aborted either spontaneously or by antiseizure medications. Also, we did not observe any seizure recurrence in any of the infants during the later stages of their treatment. Since this adverse effect might be related to the speed of the bolus administration, intravenous midazolam must be given as a slow bolus over 2-3 minutes followed by a slow flush of normal saline. To prevent midazolam's potential adverse effect on newborns, neonatal caregivers must be aware of it.

Keywords: Midazolam; Injection, intravenous, Seizures; Infant, Newborn; Hypnotics and Sedatives.