Prophylactic Treatment with Diazepam or Valproate in Children with Recurrent Febrile Seizures

PURPOSE: We tried to evaluate the effect of prophylactic treatment with short-term intermittent diazepam or long-term continuous valproate in prenventing the recurrence febrile seizures and compare the efficacy of both drugs. METHODS: Eighty six children who were admitted to the Kwangju Christian Hospital from March, 1997 to July, 1999 with more than three febrile seizures and more than one risk factor were enrolled in our study and followed up for one year. Among them, sixteen belonged to an oral diazepam group and twelve to a valproate group while fifty eight to a control group. We investigated the recurrence rate of each group for the period of a year. RESULTS: In the diazepam group, diazepam(0.3 mg/kg/dose) was administered orally every eight hours during the first febrile day and the recurrence rate was 6.2%. The recurrence rate of the valproate group(17 mg/kg/day, bid) was 25%. Those treatments significantly reduced the recurrence rates of febrile convulsions compared to the untreated control group(74.1%), but no significant differences were found between the two treatment groups in the respect of recurrence rates of febrile seizures. CONCLUSION: Both intermittent diazepam and continuous valproate treatment were equally effective in preventing the recurrence of febrile seizures.

Recurrence Rate of Febrile Seizures by Combining Risk Factors

PURPOSE: In previous studies, various risk factors for recurrent febrile seizures have been identified. But none of these risk factors alone could sufficiently discriminate children at high or low risk for recurrent seizures. Therefore, we tried to identify patients at high risk of recurrent febrile seizures by combining risk factors. METHODS: Two hundred and four children who had been admitted to our hospital from March, 1997 to July, 1999 with their first febrile seizures were enrolled in our study, and followed up over 2 years. We investigated the recurrence rate according to variables such as sex, age at first febrile seizure, family history of febrile seizures or epilepsy, type of the first seizure, neurologic abnormality and EEG abnormality. RESULTS: Family history of febrile seizures and age at first febrile seizure(or=12 months (no risk factor), 43.8%; the group with no family history and age or=12 months(one risk factor), 64.5%; group with family history and age <12 months(two risk factors), 90.4%. CONCLUSION: A correlation between numbers of risk factors and recurrence rate was present and the children with a family history of febrile seizures and a young age at onset(<12 months) were regarded as a high risk group of recurrence.