Salehiomran Mohammadreza, Hoseini Seyed Mohammad, Ghabeli Juibary Ali
Pediatric Neurologist, NonCommunicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran.
Pediatrician, Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran.
Iran J Child Neurol. 2016 Winter;10(1):21-4.
Febrile seizure is the most common neurologic problem in children between 3 months to 5 years old. Two to five percent of children aged less than five yr old will experience it at least one time. This type of seizure is age dependent and its recurrence rate is about 33% overalls and 50% in children less than one yr old. The prophylactic treatment is still controversial, so we conducted a randomized controlled clinical trial to find out the effectiveness of continuous phenobarbital versus intermittent diazepam for febrile seizure.
MATERIALS & METHODS: This clinical trial was conducted in the Department of Pediatric Neurology, Babol University of Medical Sciences, Babol, Iran between March 2008 and October 2010. All children from 6 month to 5 yr old referred to Amirkola Children's Hospital, Babol, Iran were enrolled in the study. Children with febrile seizure that had indication for prophylaxis but did not receive any prophylaxis previously were enrolled in the study. For prophylactic anti convulsion therapy, patients were divided randomly in two groups. One group received continuous phenobarbital and another treated with intermittent diazepam whenever the children experienced an episode of febrile illness for up to one year after their last convulsion.
Of all 145 studied cases, the recurrent rate in children under prophylaxis with diazepam was 11/71 and in phenobarbital group was 17/74. There was no significant difference in the recurrence rate in both groups.
There was no significant difference in the effectiveness of phenobarbital and diazepam in prevention of recurrent in febrile seizure and we think that in respect of lower complication rate in diazepam administration, it cloud be better choice than phenobarbital.
热性惊厥是3个月至5岁儿童最常见的神经系统问题。2%至5%的5岁以下儿童至少会经历一次热性惊厥。这种类型的惊厥与年龄有关,其总体复发率约为33%,1岁以下儿童的复发率为50%。预防性治疗仍存在争议,因此我们进行了一项随机对照临床试验,以确定持续使用苯巴比妥与间歇性使用地西泮预防热性惊厥的有效性。
本临床试验于2008年3月至2010年10月在伊朗巴博尔医科大学儿科神经科进行。所有6个月至5岁转诊至伊朗巴博尔阿米尔科拉儿童医院的儿童均纳入研究。有预防性治疗指征但此前未接受任何预防性治疗的热性惊厥儿童被纳入研究。对于预防性抗惊厥治疗,患者被随机分为两组。一组接受持续苯巴比妥治疗,另一组在儿童最后一次惊厥后长达一年的时间里,每当出现发热性疾病发作时接受间歇性地西泮治疗。
在所有145例研究病例中,接受地西泮预防的儿童复发率为11/71,苯巴比妥组为17/74。两组的复发率无显著差异。
苯巴比妥和地西泮在预防热性惊厥复发方面的有效性无显著差异,我们认为,鉴于地西泮给药的并发症发生率较低,它可能比苯巴比妥是更好的选择。