Once seizures have been controlled for 24-48 hours, the midazolam infusion can be tapered down at a rate of 1 mg/h every 12 hours, although more rapid titration protocols have been studied with dose reductions occurring every 4-6 hours. Ultimately, continuous EEG monitoring and patient response should guide titration off midazolam infusion.

• Masapu Dheeraj, Krishna K. N. Gopala, Sanjib Sinha, et al. A comparative study of midazolam and target-controlled propofol infusion in the treatment of refractory status epilepticus. Indian Journal of Critical Care Medicine. 2018;22(6):441-448.
• Fernandez A. High-dose midazolam infusion for refractory status epilepticus. Neurology. 2014;82(4):359-365.