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Abstract Details

Prehospital Treatment of Status Epilepticus (SE) with Diazepam Nasal Spray in Pediatric and Adult Patients with Epilepsy
Epilepsy/Clinical Neurophysiology (EEG)
P1 - Poster Session 1 (8:00 AM-9:00 AM)
11-001
Assess prehospital treatment of SE with diazepam nasal spray in patients with epilepsy aged 2-65 years.
Intranasal immediate-use seizure medications have been recommended as first-line treatment of SE in the community. The International League Against Epilepsy (ILAE) defines tonic-clonic SE and focal SE with impaired consciousness using timepoints t1, when seizures are abnormally prolonged, and t2, when long-term consequences may occur. 
Data were pooled from patient diaries of 2 long-term safety studies (total 199 patients; 4192 seizure episodes) evaluating diazepam nasal spray for seizure clusters with dosing based on age and weight. Seizures were categorized as generalized or focal. If not captured, the seizure type was inferred post hoc, with some episodes in patients with both types of seizures counted in both generalized and focal categories; some seizures could not be categorized. Seizure types were mapped to the ILAE categories and defined by t1 (treatment >5 minutes after onset for generalized and >10 minutes for focal seizures) and t2 (30 minutes for generalized and 60 minutes for focal seizures). SE episodes were analyzed by time from seizure onset to dose and dose to seizure termination, total seizure duration, and termination time ≤t2.  
Among SE episodes with generalized (n=357 episodes) or focal (n=340 episodes) seizures, median time from onset to dose was 12 and 26 minutes, from dose to seizure termination was 5 and 14 minutes, and total seizure duration was 20 and 50 minutes, respectively. For generalized SE episodes, 63.9% (228/357) terminated ≤t2; 60.3% (205/340) of focal SE episodes terminated ≤t2. In contrast, 20 SE episodes that led to hospitalization/prolonged hospitalization were reported; none were considered related to treatment.
Prehospital use of diazepam nasal spray in patients aged 2-65 years resulted in rapid termination of SE episodes with generalized and/or focal seizures. Few SE events required hospitalization.
Authors/Disclosures
Eric Segal, MD
PRESENTER 		Dr. Segal has received personal compensation for serving as an employee of Lundbeck. Dr. Segal has received personal compensation for serving as an employee of Eisai. Dr. Segal has received personal compensation for serving as an employee of Neurelis. Dr. Segal has received personal compensation for serving as an employee of Zogenix. Dr. Segal has received personal compensation for serving as an employee of Aquestive. Dr. Segal has received personal compensation for serving as an employee of Greenwich Biosciences. Dr. Segal has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Aquestive. Dr. Segal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. Dr. Segal has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Greenwhich Bioscience. Dr. Segal has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Greenwhich Bioscience. Dr. Segal has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurelis.
John M. Stern, MD, FAAN Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB Pharma. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for SK Life Science. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurelis. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceribell. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz Pharma. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for LivaNova. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for LivaNova. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Jazz. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for SK Life Sciences. Dr. Stern has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology. Dr. Stern has stock in DEARhealth. Dr. Stern has stock in Ceribell. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care.
Danielle A. Becker, MD Dr. Becker has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurelis, Inc. Dr. Becker has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sk life Science. Dr. Becker has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernus Pharmaceuticals. Dr. Becker has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis, Inc. Dr. Becker has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sk Life Science. Dr. Becker has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Jazz pharmaceuticals. Dr. Becker has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UBC. Dr. Becker has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for LivaNova. Dr. Becker has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neuropace. Dr. Becker has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus Pharmaceuticals.
Randa G. Jarrar, MD Dr. Jarrar has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuralis.
Tracy A. Glauser, MD (Childrens Hosp Med Ctr Dept of Neuro) Dr. Glauser has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurelis. Dr. Glauser has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for WebMD. The institution of Dr. Glauser has received research support from NIH. Dr. Glauser has received intellectual property interests from a discovery or technology relating to health care. Dr. Glauser has received publishing royalties from a publication relating to health care.
Jurriaan Peters, MD (Boston Childrens Hospital) Dr. Peters has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurelis. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals. Dr. Peters has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis. Dr. Peters has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for CRICO. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for UCB.
Emilio Perucca Emilio Perucca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SKB Life Sciences. Emilio Perucca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon Pharma. Emilio Perucca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GRIN Therapeutics. Emilio Perucca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sun Pharma. Emilio Perucca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda. Emilio Perucca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eisai. Emilio Perucca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Xenon Pharma. Emilio Perucca has received publishing royalties from a publication relating to health care. Emilio Perucca has received publishing royalties from a publication relating to health care.
Stella L. Ngo, PhD Dr. Ngo has received personal compensation for serving as an employee of Neurelis Inc.. Dr. Ngo has received personal compensation for serving as an employee of Neurelis Inc..
Enrique Carrazana (Neurelis, Inc.) Enrique Carrazana has received personal compensation for serving as an employee of Neurelis. Enrique Carrazana has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Hawaii-Biotech, CND Life Sciences, Apex Labs. Enrique Carrazana has stock in Neurelis, CND, Apex.
Adrian L. Rabinowicz, MD, FAAN (Neurelis, Inc.; Center for Molecular Biology and Biotechnology, Charles E. Schmidt College of Science, Florida Atlantic University) Dr. Rabinowicz has received personal compensation for serving as an employee of Neurelis, Inc. Dr. Rabinowicz has stock in Neurelis, Inc.