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˜ Although slightly higher than that in the general
population the risk of developing epilepsy in these patients
remains extremely low

˜ No data, suggest that prophylactic treatment of children

with simple febrile seizures would reduce the risk.
ÿ


˜ [ecause epilepsy is likely the result of Y


predisposition rather than structural damage to the brain
caused by recurrent simple febrile seizures.



 

 


˜Antipyretics have been shown to be 



in
preventing recurrent febrile seizures

˜£here is evidence that   anticonvulsant

therapy with phenobarbital, primidone, or valproic
acid and  

 therapy with diazepam are



in reducing febrile-seizure recurrence
!

 

 
˜ Õhildren with simple febrile seizures have approximately the
×
×of developing epilepsy by the age of 7 years as does
the general population.

˜ Õhildren who have had multiple simple febrile seizures

x are younger than 12 months at the time of their first febrile seizure
x have a family history of epilepsy
x at higher risk, with generalized afebrile seizures developing by 25
years of age in 2.4%.

˜m study has demonstrated that successful treatment of simple

febrile seizures can prevent this later development of epilepsy,

˜ £here is no evidence that simple febrile seizures cause structural

damage to the brain.
 Õhildren ~

Y  than 12 Õhildren   than 12
months at the time of their months at the time of their
first simple febrile seizure first event have an
have an approximately  approximately

probability of having probability of a second
recurrent febrile seizures. febrile seizure
˜Êf second febrile seizure chance of having at
least 1 additional recurrence.

˜£heoretical risk of a child ~
Y during a simple

febrile seizure as a result of
x documented injury
x aspiration
x cardiac arrhythmia
but to the committee's knowledge, it has never been
reported.
 Adverse effects of either
continuous or intermittent
anticonvulsant therapy

Effectiveness of Effectiveness of
continuous intermittent
anticonvulsant anticonvulsant
therapy in therapy in
preventing
recurrent febrile
! %&'! preventing
recurrent febrile
seizures. seizures.

Effectiveness of
antipyretics in
preventing recurrent
febrile seizures
[

 


 

 
 
9
  
Prevents the recurrence of simple febrile seizures
daily therapy reduces the rate of subsequent febrile seizures
must be given daily and maintained in the therapeutic range.
adverse effects :hyperactivity, irritability, lethargy, sleep disturbances, and hypersensitivity

behavioral adverse in 20% to 40% Ýisc
ti
ati
f t e Ýr.

 

9
~ 

Phenytoin has not been shown to be
effective in preventing the recurrence of
simple febrile seizures, even when the
agent is in the therapeutic range
9


in doses of 15 to 20 mg/kg per
dayreduces the recurrence rate of febrile
seizures.
adverse effects include behavioral
disturbances, irritability, and sleep
disturbances.
 
Not effective in preventing the recurrence
of simple febrile seizures.
phenobarbital v/s carbamazepine: 47% of
the children in the carbamazepine-
treated group had recurrent seizures
compared with only 10% of those in the
phenobarbital group.
3  
effective in preventing recurrent simple
febrile seizures as phenobabrital
adverse effects: rare association with fatal
hepatotoxicity thrombocytopenia, weight
loss and gain, gastrointestinal
disturbances, and pancreatitis
 ['(')Ê!*

(+
%Ê*,*
)
Ê(!'%-Ê!!'(!


(!Ê.(/01*
(!
! '%
2


ô

˜ Õhildren with a history of febrile seizures :
DÊAZEPAM PO v/s PLAÕE[O at the time of fever.
˜ £he risk of febrile seizures per person-year was decreased
 with diazepam .
˜ Adverse effects of oral and rectal diazepam and both
intranasal and buccal midazolam include :
x Lethargy
x drowsiness
x ataxia
x Respiratory depression is extremely rare, even when given by
the rectal route.
 [ 
   
 





antipyretics, in the
absence of A 11% recurrence
anticonvulsants, donǯt rate
reduce the recurrence oral A all children for
risk of simple febrile DÊAZEPAM whom diazepam
seizures. was considered a
at the time failure adverse
of fever effects

antipyretics :regularly
(every 4 hours) V/S
sporadically does not
influence outcome.

untreated
Recurrence risk :lower in control A 0%
the phenobarbital-treated group. recurrence
group, suggesting that
antipyretic instruction, is

  in
preventing febrile-seizure
recurrence
m 
 ô

 .(.10*Ê(
A simple febrile seizure is a
benign and common event in
children between the ages of 6
and 60 months
Nearly all children have an
excellent prognosis.
As such,
long-term
therapy m

recommended

there is evidence that both 



×

   therapy with
phenobarbital, primidone, or valproic acid
and intermittent therapy with oral
diazepamare   in reducing the
risk of recurrence
 .(.10*Ê(
. Ên situations in which parental anxiety
associated with febrile seizures is severe
A i ter itte t ral Ýiaze a at t e set f fe rile
ill ess ay e effective i reve ti rec rre ce.

a ti yretics ay i r ve t e c f rt f
t e c ilÝ
A [
£ t ey will t reve t fe rile seiz res