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Continuous sodium valproate or phenobarbitone in the prevention of 'simple' febrile convulsions. Comparison by a
Insights
Sodium valproate and phenobarbitone effectively prevent recurrent simple febrile convulsions in infants aged 6-18 months. Both treatments are superior to no treatment, with sodium valproate showing comparable efficacy to phenobarbitone.
Area of Science:
- Pediatrics
- Neurology
- Clinical Pharmacology
Background:
- Febrile convulsions are common in young children.
- Identifying effective treatments to prevent recurrence is crucial for patient management.
Purpose of the Study:
- To compare the efficacy of continuous sodium valproate versus phenobarbitone in preventing recurrent simple febrile convulsions.
- To assess the effectiveness of treatment compared to no treatment.
Main Methods:
- A double-blind, randomized controlled trial involving 43 children aged 6-18 months with their first simple febrile convulsion.
- Participants were assigned to receive sodium valproate, phenobarbitone, or no treatment.
- Treatment efficacy was evaluated over a mean follow-up period of 12 months.
Main Results:
- Sodium valproate demonstrated efficacy comparable to phenobarbitone in preventing recurrence.
- The untreated group experienced significantly more recurrences than the treated groups (P < 0.05).
- Both sodium valproate and phenobarbitone showed a significant reduction in recurrence rates compared to no treatment (P < 0.05).
Conclusions:
- Continuous sodium valproate and phenobarbitone are effective in preventing recurrent simple febrile convulsions in infants.
- Both antiepileptic drugs offer a significant benefit over no treatment for this condition.
- Sodium valproate presents a viable alternative to phenobarbitone for managing simple febrile convulsions.
Abstract:
Of the 265 children aged between 6 and 18 months admitted to hospital in a 26-month period each with his first febrile convulsion, there were 64 who satisfied our criteria for a simple febrile convulsion. Of these, 43 (random) were entered into a double-blind trial of continuous sodium valproate versus phenobarbitone, and 21 were untreated. The dosage was phenobarbitone 3-6 mg/kg per day; sodium valproate 30-60 mg/kg per day. 39 completed treatment (21 phenobarbitone, 18 sodium valproate), 2 in each group being withdrawn because of unacceptable side effects. Close supervision and random serum drug estimations showed compliance to be good. After a mean treatment period of 12 months (mean age 25 months) there had been one recurrence in the sodium valproate group compared with 7 in the untreated group (P less than 0.05), and 4 recurrences in the phenobarbitone group. The difference between treatment and no treatment was significant (P less than 0.05). These results suggest that in simple febrile convulsions occurring between 6 and 18 months of age sodium valproate is as effective as phenobarbitone in preventing recurrence and that either treatment is better than none.