Intermittent Diazepam versus Continuous Phenobarbital to Prevent Recurrence of Febrile Seizures: A Randomized Controlled Trial
Iranian Journal of Child Neurology,
Vol. 10 No. 1 (2016),
30 December 2015
How to Cite This Article: Salehiomran MR, Hoseini SM, Ghabeli Juibary A. Intermittent Diazepam Versus Continuous Phenobarbital to Prevent Recurrence of Febrile Seizures: A Randomized Controlled Trial. Iran J Child Neurol. Winter 2016;10(1):21-24.
Febrile seizure is the most common neurologic problem in children between 3 months to 5 years old. Two to five percent of children aged less than five yr old will experience it at least one time. This type of seizure is age dependent and its recurrence rate is about 33% overalls and 50% in children less than one yr old.
The prophylactic treatment is still controversial, so we conducted a randomized controlled clinical trial to find out the effectiveness of continuous phenobarbital versus intermittent diazepam for febrile seizure.
Materials & Methods
This clinical trial was conducted in the Department of Pediatric Neurology, Babol University of Medical Sciences, Babol, Iran between March 2008 and October 2010. All children from 6 month to 5 yr old referred to Amirkola Children’s Hospital, Babol, Iran were enrolled in the study. Children with febrile seizure that had indication for prophylaxis but did not receive any prophylaxis previously were enrolled in the study. For prophylactic anti convulsion therapy, patients were divided randomly in two groups. One group received continuous phenobarbital and another treated with intermittent diazepam whenever the children experienced an episode of febrile illness for up to one year after their last convulsion.
Of all 145 studied cases, the recurrent rate in children under prophylaxis with diazepam was 11/71 and in phenobarbital group was 17/74. There was no significant difference in the recurrence rate in both groups.
There was no significant difference in the effectiveness of phenobarbital and diazepam in prevention of recurrent in febrile seizure and we think that in respect of lower complication rate in diazepam administration, it cloud be better choice than phenobarbital.
- Febrile Seizures
Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures. Pediatrics 1978; 61:720-727.
Rosman NP, Colton T, Labazzo J, Gilbert PL, Gardella NB, Kaye EM, et al. A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures. N Engl J Med 1993; 329: 79-84.
Autret E, Ployet JL. Traitement des convulsions fébriles. Arch Pédiatr 2002; 9:91-95.
Annegers JF, Hauser WA, Shirts SB, et al. Factors prognostic of unprovoked seizure after febrile convulsion. N Engl J Med 1987; 316: 493-498.
Sulzbacher S, Farwell JR, Temkin N, Lu AS, Hirtz DG. Late cognitive effects of early treatment with phenobarbital. Clin Pediatr 1999; 38:387-394.
Millichap JG, Colliver JA. Management of febrile seizures: survey of current practice and phenobarbital usage. Pediatr Neurol 1991; 7:243-248.
Thilothammal N, Krishnamurthy PV, Kamala KG, Ahamed S, Banu K. Role of phenobarbitone in preventing recurrence of febrile convulsions. Indian Pediatr 1993; 30:637-642.
Farwell JR, Lee YJ, Hirtz DG, Sulzbacher SI, Ellenberg JH, Nelson KB. Phenobarbital for fibril seizures: effects on intelligence and on seizure recurrence. N Engl J Med 1990; 322:364 369.
Verroti A, Latini G, Trotta D, et al. Intermittent oral DZP prophylaxis in FC: its effectiveness for FC. Eur J Ped Neurol 2004; 8:131-4.
Offringa M, Newton R. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev 2012; 18 (4): CD003031. doi: 10.1002/14651858. CD003031. pub2
Rose W1, Kirubakaran C, Scott JX. Intermittent Clobazam therapy in FC. Indian J Pediatr 2005 Jan; 72(1): 31-3.
- Abstract Viewed: 470 times
- PDF Downloaded: 536 times