Related Experiment Videos
Intention to treat febrile convulsions with rectal diazepam, valproate or phenobarbitone
1University of Manchester, Department of Child Health.
Insights
Prophylactic treatment with sodium valproate or phenobarbitone did not reduce the recurrence of febrile convulsions in children. Side effects of these treatments did not justify their use in preventing future febrile seizures.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Epileptology
Background:
- Febrile convulsions are common in young children.
- Recurrent febrile convulsions can cause parental anxiety and may be associated with neurological risks.
- Effective strategies for preventing recurrence are needed.
Purpose of the Study:
- To evaluate the efficacy of prophylactic sodium valproate and phenobarbitone in preventing recurrent febrile convulsions in children.
- To compare the risk of recurrence with prophylactic treatment versus rectal diazepam rescue therapy.
Main Methods:
- A randomized controlled trial involving 186 children aged 6-72 months with specific febrile convulsion histories.
- Children were assigned to receive rectal diazepam, prophylactic sodium valproate, or prophylactic phenobarbitone.
- Recurrence rates and side effects were monitored.
Main Results:
- The overall risk of recurrence was 30%.
- Prophylactic treatment with sodium valproate or phenobarbitone did not significantly reduce the risk of recurrence.
- Significant side effects were observed in 24% of the valproate group and 61% of the phenobarbitone group.
Conclusions:
- Prophylactic anticonvulsant therapy with sodium valproate or phenobarbitone is not effective in preventing recurrent febrile convulsions.
- The adverse effects associated with these prophylactic treatments outweigh any potential benefits.
- Rectal diazepam as a rescue therapy should be considered for prolonged febrile convulsions.
Abstract:
One hundred and eighty-six consecutive children aged between six and 72 months admitted to the Manchester Children's Hospitals with a febrile convulsion in the first year of life, a complicated febrile convulsion, or more than one febrile convulsion within two years, were allocated randomly to one of three groups who were offered rectal diazepam in the event of a subsequent prolonged febrile convulsion, or prophylactic treatment with sodium valproate or phenobarbitone. Over-all risk of recurrence was 30 per cent and adequate prophylactic treatment did not lessen this risk. Side-effects in 24 per cent of the valproate group and 61 per cent of the phenobarbitone group did not justify the use of prophylactic treatment.