Intermittent diazepam and continuous phenobarbital to treat recurrence of febrile seizures: a systematic review with meta-analysis.
Convulsions triggered by fever are the most common type of seizures in childhood, and 20% to 30% of them have recurrence. The prophylactic treatment is still controversial, so we performed a systematic review to find out the effectiveness of continuous phenobarbital and intermittent diazepam compared to placebo for febrile seizure recurrence.


METHODS
Only randomized, double-blind, placebo-controlled trials were analyzed. The recurrence of febrile seizure was assessed for each drug.


RESULTS
Ten eligible clinical trials were included. Febrile seizure recurrence was smaller in children treated with diazepam or phenobarbital than in placebo group. Prophylaxis with either phenobarbital or diazepam reduces recurrences of febrile seizures. The studies were clinical, methodological, and statistically heterogeneous.


CONCLUSIONS
The effectiveness of phenobarbital and diazepam could not be demonstrated because clinical trials were heterogeneous, and the recommendation for treatment recurrence should rely upon the experience of the assistant physician yet.
Masuko
Alice Hatsue
AH
Department of Neurology, Federal University of São Paulo, SP, Brazil.
Castro
Aldemar Araujo
AA
Santos
Gustavo Rocha
GR
Atallah
Alvaro Nagib
AN
do Prado
Lucila Bizari Fernandes
LB
de Carvalho
Luciane Bizari Coin
LB
do Prado
Gilmar Fernandes
GF
D000927:Anticonvulsants / Q000008:administration & dosage*; D003975:Diazepam / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D016017:Odds Ratio; D010634:Phenobarbital / Q000008:administration & dosage*; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D003294:Seizures, Febrile / Q000517:prevention & control*; D013997:Time Factors
D000927:Anticonvulsants; D010919:Placebos; D003975:Diazepam; D010634:Phenobarbital