Addendum 1 Intravenous introduction

Blood Basic clinical condition Type of seizures EEGpattern mgofDZP level EEGchanges introduced 'tlml

after 8'

I. Prenatal encephalopathy, Spasms, myoclonic jerks, thy P 20 No changes (in awake state DP not severe R, CT: cere- polymorphic (2.7/kg) and sleep) of the paroxys-4m bral atrophy (WS) mal activity, superimposed

lvfa

2. Perinatal encephalopathy, Partial and secondarily Synchronous and asyn- 9 3.9 Arrest of the paroxysmal CG severe R, CT: poren- generalized (tonic, ad- chronous polyfocal (l/kg) activity, superimposed lvfa 7m cephalic cysts cerebral versive), (symptomatic continuous sl sp-w

atrophy generalized epilepsy)

3. Perinatal encephalopathy, Spasms, myoclonic and thy P 15 3.1 No changes of the paroxys-AD spastic tetraplegia, severe tonic jerks (2/kg) mal activity, superimposed 7m R, CT: right cerebral (WS) lvfa on the left hemisphere

atrophy

4. CM virus encephalopathy, Myoclonic and tonic Synchronous and asyn- 10 Arrest of the paroxysmal MA severe R, CT: atrophy, jerks (symptomatic gen- chronous polyfocal (l.3/kg) activity, superimposed lvfa 7m periventricular calcifica- eralized epilepsy) continuous sl sp-w

tions

5. Perinatal encephalopathy, Asymmetric or general- thy P 15 2.75 Arrest of the paroxysmal CF spastic tetraplegia, severe ized tonic jerks (2/kg) activity, appearance of 8m R, CT: cerebral atrophy (WS) focal discharges, superim-

posed lvfa

6. Prenatal encephalopathy, Spasms, myoclonic and Subcontinuous syn- 20 Decrease of the paroxysmal DMV hypotonia, severe R, tonic jerks (symptomat- chronous and asyn- (2.5/kg) activity, appearance of

9m CT: cerebral atrophy ic generalized epilepsy) chronous polyfocal focal discharges sl sp-w

7. Tuberous sclerosis, not Spasms and/or myo- Sub continuous syn- 15 3.75 Arrest of the paroxysmal SE severe R, CT: typical clonic jerks (symp- chronous and asyn- (1.5/kg) activity, superimposed lvfa 12m calcifications tomatic generalized chronous polyfocal

epilepsy) sl sp-w

8. Tuberous sclerosis, ap- Partial (adversive) and Subcontinuous syn- 10 Arrest of the paroxysmal DMF parently normal MD, secondarily generalized chronous sl sp-w (0.7/kg) activity, superimposed lvfa 28m CT: typical calcifications tonic-clonic

(LGS)

9. Tuberous sclerosis, ap- Spasms, myoclonic and Subcontinuous syn- 15 Arrest of the paroxysmal BC parently normal MD, tonic jerks chronous sl sp-w (1.3/kg) activity, superimposed lvfa

28m CT: typical calcifica tions (LGS)

10. Post encephalitic right Partial motor secondarily Sub continuous syn- 10 Arrest of the paroxysmal LV cerebral atrophy, spastic generalized chronous sl sp-w (0.6/kg) activity, appearance of

4y2m emyplegia (LGS) asymmetry of the back-ground activity, superim-posed lvfa on the left hemisphere

II. Perinatal encephalopathy, Atonic absences and Subcontinuous syn- 10 Arrest of the paroxysmal SV spastic diplegia, not tonic jerks chronous sl sp-w (0.6/kg) activity, superimposed Ivfa

4y2m severe R, CT: right (LGS) porencephalic cyst

12. Perinatal encephalopathy, Partial (adversive) tonic Subcontinuous syn- 20 1.35 No changes of the paroxys-PG not severe R, spastic and atonic absences chronous sl sp-w and (0.9/kg) mal activity, superimposed 7y hemiplegia sbd ("unorganized lvfa

pattern") (LGS)

(p BZP tr)

R: psychomotor or/and mental retardation, CT: computed tomography, WS: West syndrome, LGS: Lennox-Gastaut syndrome, thy p: typical hypsarrhythmic pattern, sbd: slow background disorders, sl sp-w: slow spikes and waves, Ivfa: low voltage fast activity, p BZP tr: previous benzodiazepine treatment, MD: mental development.

De Negri et al: Rapid diazepam introduction in epilepsy 25

Addendum 2 Rectal introduction

mgof Blood Basic clinical Type EEG pattern DZP level EEG changes condition of seizures introduced 'Y/ml

after 15'

1. No signs of en· Spasms thy P 8 No changes of the VR cephalopathy (cryptogenic WS) (I/kg) paroxysmal activity 4m

2. Post ·encephalit· Spasms thy P 8 0.55 No changes of the MS ic cerebral atrophy, (symptomatic WS) (I/kg) paroxysmal activity 6m hypotonia, severe R

3. No signs of en· Spasms thy P 8 0.81 No changes of the GG cephalopathy (cryptogenic WS) (I/kg) paroxysmal activity 7m

4. Perinatal encepha· Hemilateral Discontinuous hypsarrhythmic 10 0.43 No changes of tHe BGL lopathy, spastic tet· spasms pattern on the right hemisphere (l/kg) paroxysmal activity,

9m raplegia, eT: right (symptomatic WS) superimposed lvfa cerebral, atrophy

5. Prenatal encepha· Atonic and Sub continuous synchronous 5 0.9 Arrest of the par· se lopathy, not severe astatic absences sl sp·w (0.5/kg) oxysmal activity,

16m R (LGS) superimposed lvfa

6. Perinatal encepha· Massive myo· Sub continuous synchronous 11 0.85 No changes of the SS lopathy, not severe clonic jerks and asynchronous sl sp·w and (l/kg) (rectal) paroxysmal activity,

3y2m R, eT: cerebral spa ("unorganized pattern") (both rectal 3 superimposed Ivfa atrophy (symptomatic generalized epilepsy) and venous) (venous)

(p BlP tr)

7. Perinatal encepha· Lateral and A wake: paroxysmal discharges 10 0.7 Arrest of the par· SMe lopathy, not severe secondarily on the right hemisphere, sleep: (l/kg) (rectal) oxysmal activity, 3y3m R, eT: periventric· generalized sub continuous synchronous (both rectal 2.3 superimposed lvfa

ular calcifications sl sp·w and venous) (venous) (epilepsy with continuous sp·w during slow wave sleep)

8. No signs of en· Tonic and A wake: paroxysmal discharges 25 0.55 Arrest of the par· RLM cephalopathy, not atonic absences on the right hemisphere, sleep: (l/kg) oxysmal activity, 5y 8m severe R subcontinuous synchronous superimposed lvfa

sl sp·w (epilepsy with continuous sp·w during slow wave sleep)

9. Prenatal encepha· Partial general· Subcontinuous unorganized 24 0.35 No changes of the AR lopathy, severe R ized tonic and paroxysmal and sbd (l/kg) paroxysmal and 6y tonic·clonic ("unorganized pattern") slow activity, super·

(Symptomatic generalized epilepsy) imposed lvfa

10. Perinatal encepha· Myoclonic jerks, Subcontinuous asymmetric 20 0.6 Decrease of the par· SE lopathy, spastic generalized sl sp·w predominant on the (l/kg) oxysmal activity

7y 10m tetraplegia tonic·clonic rightsbd ("unorganized pattern")

(symptomatic generalized epilepsy)

II. Prenatal encepha· Myoclonicjerks, Subcontinuous synchronous 25 0.63 No changes of the MF lopathy, severe R absences and and a synchronous sl sp·w (l/kg) paroxysmal activity

7y 11m atonic absences ("unorganized pattern") (LGS)

(p BlP tr)

12. No signs of en· Partial general· Sub continuous synchronous 30 0.43 Brief decrease of BMA cephalopathy, eT: ized tonic and sl sp·w (l/kg) the paroxysmal

10y4m occipital calcifica· atonic absences activity tions (symptomatic generalized epilepsy)

(p BlP tr)

R: psychomotor and/or mental retardation, eT: computed tomography, WS: West syndrome, LGS: Lennox·Gastaut syndrome, thy p: typical hypsarrhythmic pattern, sbd: slow background disorders, sl sp·w: slow spikes and waves, lvfa: low voltage fast activity, p BlP tr: previous benzodiazepine treatment, MD: mental development.

26 Brain & Development, VOIl3, No 1, 1991