[Discontinuous selective prophylaxis of febrile convulsions at home with rectal diazepam]

Abstract

Selective episodic prophylactic home treatment with rectal diazepam in children with febrile convulsions should reduce the risks of permanent long term anticonvulsive drug therapy. To evaluate this approach and its side effects, selective prophylaxis (rectal diazepam, 0.6 mg x kg at 8 to 12 hour intervals) was given to 15 children with previous febrile convulsions whenever their axillary temperature raised to 38 C degrees or over. They were followed up for a mean of 7.73 months (range 3 to 20 months). In a total of 27 febrile episodes only 2 seizures occurred, each to a different patient and in both cases when treatment was inadvertently withheld. No recurrences were observed in the remaining 13 patients involving 25 treated febrile crisis. The small number of patients precluded evaluation of the effects of risk factors in recurrence rates. Mild and transient collateral effects were detected in 46.6% patients and in 32.0% of the observed febrile periods. In spite of the small number of patients and short follow-up period these results suggest, that episodic, non permanent, treatment with rectal diazepam is an appropriate alternative to traditional continuous oral anticonvulsive therapy for children with febrile convulsions.