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December 15, 2020; 95 (24) Article

Prehospital midazolam use and outcomes among patients with out-of-hospital status epilepticus

Elan L. Guterman, Joseph K. Sanford, John P. Betjemann, Li Zhang, James F. Burke, Daniel H. Lowenstein, S. Andrew Josephson, Karl A. Sporer
First published September 17, 2020, DOI: https://doi.org/10.1212/WNL.0000000000010913
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Article Information

vol. 95 no. 24 e3203-e3212
DOI: 
https://doi.org/10.1212/WNL.0000000000010913
PubMed: 
32943481
Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received March 5, 2020
  • Accepted in final form August 3, 2020
  • First Published September 17, 2020.

Article Versions

Copyright & Usage: 
© 2020 American Academy of Neurology

Author Disclosures

    1. Elan L. Guterman, MD,
    2. Joseph K. Sanford, MD,
    3. John P. Betjemann, MD,
    4. Li Zhang, PhD,
    5. James F. Burke, MD, MS,
    6. Daniel H. Lowenstein, MD,
    7. S. Andrew Josephson, MD and
    8. Karl A. Sporer, MD
  1. Elan L. Guterman, MD,
    2. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Funding for travel from the American Academy of Neurology to attend the annual conference.

    Editorial Boards:

    1. (1) The Neurohospitalist, Associate Editor, 2019-present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. (1) Marinus pharmaceuticals, Inc

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. (1) National Institute on Aging, 5R01AG056715, co- investigator, 2019-present (2) National Institute of Neurological Disorders and Stroke, 1K23NS116128-01, principal investigator, 2020- present

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  2. Joseph K. Sanford, MD,
    3. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  3. John P. Betjemann, MD,
    4. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. American Academy of Neurology Annual Meeting, speakers honoraria

    Editorial Boards:

    1. JAMA Neurology, web editor, 2017-2020

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  4. Li Zhang, PhD,
    5. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. 1. Integrative Genomic Analysis Reveals Extended Germline Homozygosity With Lung Cancer Risk In The PLCO Cohort, for which application for letters patent of the united states has been filed on 02/19/2013 under Serial No. 61/766,261. Systematically integrating differential expression of specific genes residing in critical intervals such as tracts of homozygosity, have revealed new candidate lung cancer-risk-genes, as well as genes previously shown to play a somatic role in sporadic human lung carcinomas, in murine models and/or participate in neoplasia-associated signaling pathways. 2. Treatment of pulmonary hypertension using JAK inhibition, for which application for letters patent of the united states has been filed on 04/28/2014 under Serial No. 61/985,176. aberrant JAK-STAT signaling in MF mediates PH by dysregulation of NO and cytokines levels which can be restored by therapy with JAK inhibitors. This suggests that inhibition of the JAK-STAT signaling pathway is a novel and viable target for the management of patients with Myelofibrosis-associated pulmonary hypertension . 3. T cell repertoire diversity as a biomarker for side effects associated with immune checkpoint inhibitor treatment.

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. Commercial: MagArray Inc Commercial: Raydian Oximetry Inc Non-profit: Alisa Ann Ruch Burn Foundation Non-profit: Smith-Kettlewell Eye Research Institute

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  5. James F. Burke, MD, MS,
    6. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. 1. Associate Editor at Circulation: Cardiovascular Quality and Outcomes from 7/2016-current

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. Dr. Burke is funded by NIH R01 MD008879 and R01 AG059733.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  6. Daniel H. Lowenstein, MD,
    7. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Philadelphia College of Osteopathic Medicine; travel and speaker honorarium Translational Research for Space Health; travel and honorarium

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NIH: U01NS088034, Co-PI, 8/12-9/20 Epilepsy Study Consortium, PI, 8/12-6/21

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  7. S. Andrew Josephson, MD and
    8. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. JAMA Neurology, Editor in Chief, 2017-present Continuum Online Edition, Associate Editor 2011-present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  8. Karl A. Sporer, MD
    9. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Editorial Board Member, Prehospital Emergency Care Decision Editor, Journal of the American College of Emergency Physicians, Open

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  1. From the Department of Neurology (E.L.G., J.K.S., J.P.B., D.H.L., S.A.J.), Weill Institute for Neurosciences (E.L.G., J.K.S., J.P.B., D.H.L., S.A.J.), Department of Epidemiology & Biostatistics (L.Z.), Department of Medicine (L.Z.), and Department of Emergency Medicine (K.A.S.), University of California, San Francisco; and Department of Neurology (J.F.B.), University of Michigan, Ann Arbor.
  1. Correspondence
    Dr. Guterman Elan.Guterman{at}ucsf.edu
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Cited By...

Disputes & Debates: Rapid online correspondence

  • Author response: Prehospital midazolam use and outcomes among patients with out-of-hospital status epilepticus
    • Elan L. Guterman, Neurologist, University of California, San Francisco
    • Joseph K. Sanford, Neurologist, University of California, San Francisco
    • John P. Betjemann, Neurologist, Kaiser Permanente
    • Li Zhang, Statistics, University of California, San Francisco
    • James F. Burke, Neurologist, University of Michigan
    • Daniel H Lowenstein, Neurologist, University of California, San Francisco
    • S. Andrew Josephson, Neurologist, University of California, San Francisco
    • Karl A. Sporer, Emergency Medicine, University of California, San Francisco
    Submitted January 06, 2021
  • Reader response: Prehospital midazolam use and outcomes among patients with out-of-hospital status epilepticus
    • Christoph Kellinghaus, Neurologist, Dept. of Neurology, Klinikum Osnabrück, Osnabrück, Germany
    • Andrea O. Rossetti, Neurologist, Department of Clinical Neurosciences, CHUV and University of Lausanne, Switzerland
    • Stephan Rüegg, Neurologist, Department of Neurology, University Hospital Basel, Switzerland
    • Eugen Trinka, Neurologist, Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
    • Felix Rosenow, Neurologist, 12Epilepsy Center Frankfurt Rhein-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt,
    Submitted December 23, 2020
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