Efficacy of midazolam combined with acetaminophen for children with complex febrile seizures
SONG Yangang
ZHANG Yongfeng
SUN Hesheng
QIAN Mei
Abstract：Objective To investigate the clinical efficacy of midazolam combined with acetaminophen in children with complex febrile seizures.Methods A retrospective cohort study was conducted.Medical records of children with complex febrile seizures admitted to Suzhou BenQ Medical Center from January 2022 to December 2024 were collected from the electronic medical record system,with a total of 103 cases included.According to the actual treatment regimens recorded in the medical re-cords,the children were divided into two groups:those who received acetaminophen monotherapy were included in the monother-apy group(53 cases),and those who received midazolam combined with acetaminophen were included in the combination therapy group(50 cases).Clinical efficacy,treatment-related time indicators(time to seizure cessation,time to fever reduction,length of hospital stay),serum levels of brain injury markers(neuron-specific enolase,S-100β protein,glial fibrillary acidic protein),and incidence of adverse reactions were extracted from medical records and compared between the two groups.Results The total effective rate in the combination therapy group was 88.00%(44/50),higher than 67.92%(36/53)in the monotherapy group(χ²=5.979,P=0.014).The time to seizure cessation,time to fever reduction,and length of hospital stay in the combination ther-apy group((2.38±0.35)min,(4.91±1.04)h,(4.20±0.63)d,respectively)were all shorter than those in the monotherapy group((4.79±0.71)min,(6.54±1.23)h,(6.36±0.95)d,respectively),with statistically significant differences(t=21.645,7.241,13.515,all P<0.05).After treatment,the serum levels of S-100β protein,neuron-specific enolase,and glial fibrillary acidic protein in both groups decreased compared to pre-treatment,and the levels of these indicators in the combination therapy group((0.52±0.07)μg/L,(14.56±1.72)ng/L,(30.24±3.60)ng/L,respectively)were significantly lower than those in the monotherapy group((0.93±0.11)μg/L,(18.03±1.98)ng/L,(38.65±4.63)ng/L,respectively)(t=22.416,9.471,10.249,all P<0.05).The incidence of adverse reactions was 14.00%(7/50)in the combination therapy group and 5.66%(3/53)in the monotherapy group,with no statistically significant dif-ference(χ²=0.813,P=0.367).Conclusion For children with complex febrile seizures,the treatment regimen of midazolam com-bining with acetaminophen can obtain the higher clinical efficacy,shorter time to symptom resolution and hospital stay,and lower serum levels of brain nerve injury markers,without significantly increasing the risk of adverse reactions.
Keywords：complex febrile seizureschildrenmidazolamacetaminophenclinical efficacybrain nerve injury markers
Publication Date：2026-03-25
Online Publishing Date：2026-04-07(First online date of this platform, not the publication date of the document)
Pages：5( 320-324 )