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Intermittent prophylaxis in febrile convulsions: diazepam or valproic acid?
1Department of Paediatrics, Glostrup Hospital, Denmark.
Acta Neurologica Scandinavica
|July 1, 1990
Summary
Valproic acid and diazepam showed similar recurrence rates for febrile seizures in children. Valproic acid may be effective, but complex seizures were more frequent, and parental compliance was a challenge.
Area of Science:
- Pediatrics
- Neurology
- Pharmacology
Background:
- Febrile seizures are common in children.
- Intermittent prophylaxis aims to prevent seizure recurrence.
- Diazepam and valproic acid are used for seizure management.
Purpose of the Study:
- To compare the efficacy and safety of intermittent diazepam versus valproic acid for preventing febrile seizure recurrence.
- To assess recurrence rates and types of seizures in children receiving prophylaxis.
Main Methods:
- An open, prospective, randomized, hospital-based study.
- 219 children were enrolled; 169 received 1-year intermittent prophylaxis.
- Diazepam (rectal) or valproic acid (suppositories) administered at times of fever.
Main Results:
- 12-month recurrence rates were similar: 27% for diazepam vs. 20% for valproic acid.
- Complex recurrences were significantly higher in the valproic acid group.
- Parental non-compliance was noted; 69 children had side-effects with diazepam vs. 37 with valproic acid (none serious).
Conclusions:
- Intermittent valproic acid may be effective in reducing febrile seizure recurrence, though further research is needed.
- Valproic acid was associated with more complex recurrences, while diazepam had more frequent side-effects.
- Parental compliance is a critical factor in the effectiveness of intermittent prophylaxis for febrile seizures.