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DIAZEPAM MAY PREVENT RECURRENT FEBRILE SEIZURES.

Febrile seizures are not uncommon in young children and recur in about a third of all cases. Phenobarbital and other anticonvulsants have been used to prevent recurrences, but these treatments are plagued by significant side effects. This randomized trial compared oral diazepam with placebo in 406 children with at least one prior febrile seizure.

The medication was started any time the child became febrile and given every 8 hours until the child had been afebrile for 24 hours. During a mean follow-up of almost 2 years, children taking diazepam (0.33 mg/kg) had significantly fewer febrile seizures than those taking placebo (41 vs. 72). Moreover, 34 of the 41 seizures in the diazepam group occurred when the child had not received the drug, usually because the seizure began before a temperature elevation was noted. Although moderate side effects occurred in 39 percent of children given diazepam, they led only 1 child to withdraw from the study.

Comment: Diazepam, given at the earliest sign of febrile illness, appears to prevent a substantial number of recurrent febrile seizures. The authors believe that diazepam should now be considered the best prophylactic drug for this purpose.

— ASB

Published in Journal Watch General Medicine July 16, 1993

Citation(s):

Rosman NP et al. A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures. N Engl J Med 1993 Jul 8 329 79-84.

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