Febrile convulsions: Review of 284 patients and the evaluation of intermittant prophylaxis

Abstract

Two-hundred eighty four children with febrile seizures (FS) admitted to our hospital were evaluated between 1992 and 1996. The onset of febrile seizures in 268 children were between 1 and 72 months (mean: 21,2 months). Two-hundred fifty three children (89%) had simple and 31 children (11%) had complex febrile seizures. The duration of seizures could be detected in 236 children and in 22 children seizures lasted for 15 minutes or longer. Eighty-five children (30%) had positive family history for FS. Electroencephalography (EEC) was performed in 196 children (69%) after the first febrile seizure. Pathologic findings on EEC in 59 children (30,1 %) were detected. Intermittent rectal diazepam prophylaxis was administered to 178 children, when the child's fever was 38,5 C and above. Sixty children (33,7%) came to their follow-ups. Follow-up period was 3-48 months (mean: 14,75 months). In 47 children seizures did not recur. Recurrence of seizures were noted in 13 children, because rectal diazepam could not be applied at the time of high fever. Phenobarbital was given to 28 children as initial prophylactic therapy and 27 children came to their follow-ups. The follow up period was 12-48 months. In one patient seizure recurred during therapy. Eleven children were treated with Na valproate. In 6 children seizures did not recur within 2 years. Follow up was lost in 5 children. Five children developed afebrile seizures. Afebrile seizures occurred in 2 cases after the termination of phenobarbital therapy and they were put on valproate therapy. Long term prophylaxis with phenobarbital because of its side effects is not preferred. Rectal diazepam administration at the onset of fever decreased the recurrence rate of FS and was devoid of major side-effects. Therefore rectal diazepam is preferred for prophylactic treatment of FS.