It is not uncommon for the child with a BT to experience seizures. The goal of seizure management at EOL is distinct from managing chronic epilepsy, particularly in an unresponsive patient. Midazolam is frequently used for its anticonvulsant and sedative properties. It can be administered subcutaneously/intravenously, via the intranasal or buccal route, and as a rapid onset. Seizures that are refractory to midazolam at EOL can be often effectively managed with parenteral phenobarbital.