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Therapeutic Options in the Management of Febrile Seizures

 

作者: N. Paul Rosman,  

 

期刊: CNS Drugs  (ADIS Available online 1997)
卷期: Volume 7, issue 1  

页码: 26-36

 

ISSN:1172-7047

 

年代: 1997

 

出版商: ADIS

 

数据来源: ADIS

 

摘要:

Febrile seizures are common events, affecting at least 2 to 5% of children. They occur more often in boys. Most are ‘simple’, i.e. are generalised, shorter than 15 minutes in duration, and do not recur within 24 hours. When the seizures are focal or prolonged, or recur within a day, they are called ‘complex’. One-third of febrile seizures recur, with recurrences more frequent when febrile seizures begin in the first year of life, the initial febrile seizure is complex, the fever triggering the first febrile seizure has been brief and of low grade, there is a family history of febrile seizures or epilepsy, and the child is developmentally or neurologically abnormal. Children with febrile seizures are at an increased risk for later epilepsy, particularly when febrile seizures recur and especially when they are complex.Although a clinician may elect not to treat children to prevent recurrences of febrile seizures, there are stronger arguments in favour of treatment, including the prevention of major parental anxiety and family disruption, reduction of medical costs, and reduction in the risk of neurological morbidity. Daily medication with oral phenobarbital (phenobarbitone), primidone or valproic acid (sodium valproate) is often effective as prophylaxis against febrile seizures. Intermittent medication, however, taken only at the times of fever, is preferable since efficacy is higher and adverse effects lower. Antipyretics alone do not prevent febrile seizures from recurring, but intermittent therapy with benzodiazepines (rectal or oral diazepam and possibly oral nitrazepam or clobazam) is highly effective in lowering the recurrence risk. Whether this lessens the risk of later epilepsy is unknown.

 

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