Effectiveness of intermittent diazepam prophylaxis in febrile seizures: long-term prospective controlled study.
The efficacy of intermittent rectal diazepam prophylaxis is assessed in the prevention of febrile seizures. In a prospective randomized cohort trial, 139 children (77 girls, 62 boys) who experienced a first febrile seizure were allocated to two groups: group A, which received intermittent diazepam (n = 68), and group B, which received no prophylaxis (n = 71). All children had a 3-year follow-up. The inclusion criteria were no personal history of afebrile seizures, normal neurodevelopment, no previous anticonvulsant therapy, and age between 6 months and 3 years. Each group was stratified to low, intermediate, and high risk according to the available clinical data. The 36-month recurrence rates in the no-prophylaxis group were 83% in high-risk patients, 55% in intermediate-risk patients, and 46% in low-risk patients. In the prophylaxis group, the recurrence rates were reduced in all risk groups: 38%, 35%, and 33%, respectively. Intermittent diazepam prophylaxis reduces the recurrence rate mainly in high-risk children provided that sufficient doses are given on time and adequately.
Pavlidou
Efterpi
E
3rd Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Tzitiridou
Maria
M
Panteliadis
Christos
C
D000367:Age Factors; D017668:Age of Onset; D000927:Anticonvulsants / Q000008:administration & dosage*; D001921:Brain / Q000187:drug effects / Q000254:growth & development / Q000503:physiopathology; D002675:Child, Preschool; D003975:Diazepam / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D003294:Seizures, Febrile / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D013995:Time; D016896:Treatment Outcome
D000927:Anticonvulsants; D003975:Diazepam