Home treatment of seizures as a strategy for the long-term management of febrile convulsions in children.

A cooperative study evaluating compliance and efficacy of Diazepam clisma in home treatment of febrile seizures in children was conducted from January 1979 to June 1981. Parents of 601 children admitted to hospital for a febrile convulsion were taught to use Diazepam clisma in the eventuality of a new seizure and asked to record the length of the episode. Complete follow-up was possible in 564 cases for an average time of 16.7 months. During the research period 109 convulsive episodes were registered in 76 children. Four of these children presented a seizure without fever. Diazepam clisma was administered correctly in 70 episodes (64.2%). In 26 of the remaining 39 cases, therapy was not administered because the seizure ended before the treatment was started. Prolonged seizures (greater than 15 min) have been reported in 8 cases. Six were in the non-treated group and 2 in the treated group. In both these last cases Diazepam was expelled immediately after being administered. The results of the study suggest that home treatment of febrile convulsions by Diazepam clisma represents a well accepted and useful strategy for prevention of prolonged seizures, provided that continuous contact and complete understanding between family and physician can be ensured.

Effect of human erythrocyte stromata on complement activation.

Stroma from either normal or PNH-like red cells is capable of inhibiting, to some extent, lysis in the sucrose test and enhancing lysis in the acidified-serum test. The same opposing effects are displayed by the exclusion peaks from Sephadex G-200 obtained from each stroma preparation, suggesting that the same factor could be responsible for both activities. Stromata and peaks also induce lysis of PNH-like cells in unacidified serum, indicating activation of complement through the alternate pathway. This is confirmed by immunoelectrophoretic observation. When serum previously activated through the alternate pathway is used in the sucrose test the amount of lysis is markedly reduced. This would indicate that the classical pathway activation can be controlled by the alternate pathway. The possible clinical significance of these factors in determining the haemolytic crisis in PNH patients is discussed.