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Management of febrile seizures: survey of current practice and phenobarbital usage

J G Millichap1, J A Colliver

  • 1Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield.

Pediatric Neurology
|July 1, 1991
PubMed

Insights

Pediatric neurologists frequently use phenobarbital for long-term management of complex febrile seizures, with parental anxiety influencing treatment decisions. Awareness of phenobarbital side effects has limited impact on current prescribing practices for febrile seizures.

Area of Science:

  • Pediatric Neurology
  • Clinical Practice Guidelines
  • Pharmacology

Background:

  • Febrile seizures are common in children, with varied management approaches.
  • Phenobarbital is a widely used antiepileptic drug, but concerns about its side effects exist.
  • Understanding current practices in febrile seizure management is crucial for optimizing care.

Purpose of the Study:

  • To survey pediatric neurologists in North America regarding their management of febrile seizures.
  • To assess the influence of public awareness of phenobarbital side effects on clinical practice.
  • To identify factors, such as parental anxiety, affecting treatment decisions.

Main Methods:

  • A questionnaire was mailed to all members of the Child Neurology Society in North America.
  • Response rate was 66% (574 out of 869 deliverable questionnaires).
  • Data collected included the number and type of febrile seizures treated and prescribing habits for various antiepileptic drugs.

Main Results:

  • Intravenous phenobarbital, lorazepam, and diazepam were equally preferred for acute febrile seizures; phenytoin was used infrequently.
  • Diazepam was prescribed by 20% for seizure prevention and 31% for recurrence control by parents.
  • Long-term phenobarbital was prescribed by 89% for complex and 43% for simple febrile seizures; parental anxiety influenced 67% of therapy decisions.

Conclusions:

  • Phenobarbital remains a common choice for long-term febrile seizure management, particularly for complex cases.
  • Parental anxiety significantly impacts treatment decisions in febrile seizure management.
  • Current practices show limited influence from public awareness of phenobarbital side effects.

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