[Preventing the recurrence of febrile seizures: intermittent prevention with rectal diazepam compared with continuous
C Mosquera1, J Rodríguez, A Cabrero
1Servicio de Pediatría, Hospital Camino de Santiago, Ponferrada, León.
Insights
For children experiencing a first febrile seizure, continuous oral sodium valproate prevented recurrences. Intermittent rectal diazepam also reduced seizure recurrence compared to no treatment.
Area of Science:
- Pediatrics
- Neurology
- Clinical Pharmacology
Background:
- Febrile seizures are common in children.
- Prophylaxis is often requested by parents but its necessity is debated.
Observation:
- A study followed 69 children with first febrile seizures over two years.
- Patients were randomized into three groups: no treatment, intermittent rectal diazepam, or continuous oral sodium valproate.
Findings:
- The control group had a 16% recurrence rate.
- The diazepam group showed a 5.5% recurrence rate.
- The sodium valproate group had no recurrences during the follow-up period.
Implications:
- Continuous oral sodium valproate appears highly effective in preventing febrile seizure recurrence.
- The low recurrence rate in the untreated group questions the routine need for prophylaxis.
- Further research may clarify optimal management strategies for febrile seizures.
Abstract:
Sixty nine children suffering from a first febrile seizure without evidence of neurologic disorder or associated risk factors were randomly assigned to one of three groups: no treatment; intermittent rectal diazepam; or continuous oral sodium valproate. All patients were followed for two years. Periodical controls were performed every three months in order to record febrile episodes, recurrent seizures, and treatment side affects. Rate of recurrent febrile seizures was 16% in control group, and 5.5% in diazepam group. Sodium valproate group showed no recurrences in the follow-up period. The low relapsing rate in control group suggests that prophylaxis should not be established even if it is requested by certain parental attitudes.
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