A meta-analytic review of the preventive treatment of recurrences of febrile seizures

Rantala, Heikki; Tarkka, Rita; Uhari, Matti

doi:10.1016/s0022-3476(97)70045-3

Cited by 75 publications

(43 citation statements)

References 27 publications

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“…Because of the severe negative side effects and the debatable efficacy, continuous antiepileptic treatment of children with febrile seizures nowadays is considered obsolete in general, unless there are strong indications for its use. 14 Accordingly, intermittent preventive treatment with diazepam during fever is associated with adverse effects and has not been proven effective in a meta-analysis 14 ; only children with a high risk of febrile seizure recurrence may benefit from intermittent diazepam in an oral dose of 0.33 mg/kg administered every 8 hours during fever. 31 The decision to prescribe it should be made in consultation with the parents because of its negative side effects, the necessity of regular medical check ups, and the difficulty of early recognition of a feverish illness.…”

Section: Discussionmentioning

confidence: 99%

Randomized, Controlled Trial of Ibuprofen Syrup Administered During Febrile Illnesses to Prevent Febrile Seizure Recurrences

et al. 1998

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ABSTRACT. Objectives. Febrile seizures recur frequently. Factors increasing the risk of febrile seizure recurrence include young age at onset, family history of febrile seizures, previous recurrent febrile seizures, time lapse since previous seizure <6 months, relative low temperature at the initial seizure, multiple type initial seizure, and frequent febrile illnesses. Prevention of seizure recurrences serves two useful purposes: meeting parental fear of recurrent febrile seizures in general and reducing the (small) risk of a long-lasting and eventually injurious recurrent seizure. In daily practice, children with febrile seizures often are treated with antipyretics during fever to prevent febrile seizure recurrences. Thus far, no randomized placebo-controlled trial has been performed to assess the efficacy of intermittent antipyretic treatment in the prevention of seizure recurrence.Methods. We performed a randomized, doubleblind, placebo-controlled trial. Children 1 to 4 years of age who had had at least one risk factor for febrile seizure recurrence were enrolled. They were randomly assigned to either ibuprofen syrup, 20 mg/mL, 0.25 mL ‫؍(‬ 5 mg) per kilogram of body weight per dose, or matching placebo, to be administered every 6 hours during fever (temperature, >38.5°C). Parents were instructed to take the child's rectal temperature immediately when the child seemed ill or feverish and to promptly administer the study medication when the temperature was >38.5°C. Doses were to be administered every 6 hours until the child was afebrile for 24 hours. The parents were instructed not to administer any other antipyretic drug to the child. For measuring rectal temperature, a Philips HP5316 digital thermometer (Philips, Eindhoven, The Netherlands) was distributed. During subsequent treatment of the fever episode, parents had to call the investigator at least once each day to notify the investigator in case of febrile seizure recurrence. The investigator could be contacted by parents 24 hours per day.The primary outcome was the first recurrence of a febrile seizure. Kaplan-Meier curves and Cox regression were used for the statistical analysis. The treatment effect on the course of the temperature was assessed using analysis of covariance, with temperature at fever onset as covariate. Two analyses were performed. In an intention-to-treat analysis, all first recur-

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Section: Discussionmentioning

confidence: 99%

Randomized, Controlled Trial of Ibuprofen Syrup Administered During Febrile Illnesses to Prevent Febrile Seizure Recurrences

et al. 1998

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“…Only a single placebo-controlled trial has been performed to date (Chiron et al, 2000). Improved but incomplete seizure control has been reported with bromides (Tanabe et al, 2008), valproate (Rantala et al, 1997), topiramate (Nieto-Barrera et al, 2000;Coppola et al, 2002), stiripentol (Perez et al, 1999;Chiron et al, 2000;Inoue et al, 2009), and clobazam (Chiron et al, 2000;Thanh et al, 2002;Chiron and Dulac, 2011) in various combinations, whereas the sodium channel blockers lamotrigine and carbamazepine exacerbate seizures (Guerrini et al, 1998;Thanh et al, 2002) in a majority of patients.…”

Section: Introductionmentioning

confidence: 99%

Synergistic GABA-Enhancing Therapy against Seizures in a Mouse Model of Dravet Syndrome

Oakley

Cho

Cheah

et al. 2013

J Pharmacol Exp Ther

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“…The controversy about the effectiveness of oral and rectal diazepam still persists. Meta-analysis by Rantala et al 19 showed that intermittent diazepam had no prophylactic effect on decreasing recurrences, but this meta-analysis is still on debate.…”

Section: Discussionmentioning

confidence: 96%

Predictors for the recurrent febrile seizures after the first complex febrile seizures

Tanjung¹,

Mangunatmadja²,

Sastroasmoro³

et al. 2016

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Background Complex febrile seizures (CFS) have been shownto be related to recurrence and epilepsy. Many studies were doneto determine the predictors of recurrence in both simple and com-plex febrile seizures. To our knowledge until now there is no pub-lished data that specially looks for predictors of recurrence after afirst CFS.Objective To find out clinical and demographical characteristicsof a first CFS and to define the predictors for the recurrent febrileseizures.Methods Prospective survival analysis study was done in chil-dren with first CFS who visited Cipto Mangunkusumo Hospital,Jakarta, over 14 months periods. The predictors for developmentof recurrence were analyzed by SPSS for Windows 11.5 usingKaplan-Meier test and Cox regression model with a level of signifi-cance <0.05.Results There were 62 subjects completed this study. Male-to-female ratio was 1.4:1. The mean age at onset was 18.2 months.Recurrence occurred in 9 subjects (14.5%). Body temperaturebetween 38-38.5°C (7 of 26 subjects, P=0.02), upper motor neu-ron type of delayed development (3 of 7 subjects, P=0.03), andepileptic history in the family (2 of 2 subjects, P<0.05) were asso-ciated with recurrence in bivariate analysis. In multivariate analy-sis only body temperature between 38-38.5°C (HR 1.6, 95% CI1.0;23.9) and epileptic history in the family (HR 16.9, 95% CI2.8;101.4) were identified as predictors.Conclusion Low body temperature at the first seizures and epi-leptic history in the family were independent predictors for the re-currence after a first CFS

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A meta-analytic review of the preventive treatment of recurrences of febrile seizures

Cited by 75 publications

References 27 publications

Randomized, Controlled Trial of Ibuprofen Syrup Administered During Febrile Illnesses to Prevent Febrile Seizure Recurrences

Randomized, Controlled Trial of Ibuprofen Syrup Administered During Febrile Illnesses to Prevent Febrile Seizure Recurrences

Synergistic GABA-Enhancing Therapy against Seizures in a Mouse Model of Dravet Syndrome

Predictors for the recurrent febrile seizures after the first complex febrile seizures

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