Wolf S M, Carr A, Davis D C, Davidson S, Dale E P, Forsythe A, Goldenberg E D, Hanson R, Lulejian G A, Nelson M A, Treitman P, Weinstein A
Pediatrics. 1977 Mar;59(3):378-85.
A group of 355 children who were seen after a first febrile convulsion at the Kaiser Foundation Foundation Hospitals in Southern California from 1970 to 1975 were randomly assigned to three treatment groups-daily phenobarbital, "intermittent" phenobarbital given at the onset of fever, and no phenobarbital. We found that 42% had a relative with a febrile seizure and 16% a relative with an afebrile convulsion. 13% had seizures which were either lateralized or longer than ten minutes. Parents were unaware of the fever prior to the seizure in about 30% of the cases. In 81% the preseizure duration of fever was less than 24 hours. The mean follow-up was 28 months, with a range of 6 to 70 months. There was no significant difference in the recurrence rate between children receiving "intermitent" as compared with no phenobarbital. The recurrence rate in children receiving daily phenobarbital was significantly decreased compared to either of the other two groups. Severe recurrent febrile seizures occurred in no children on daily phenobarbital and in 4.4% of the children receiving either intermittent or no phenobarbital. Parental resistance, compliance, and reversible hyperactivity were the main problems encountered with the continuous phenobarbital regimen.
1970年至1975年期间，在南加州凯撒基金会医院首次出现热性惊厥后接受诊治的355名儿童被随机分为三个治疗组：每日服用苯巴比妥组、发热开始时服用“间歇性”苯巴比妥组和不服用苯巴比妥组。我们发现，42%的儿童有热性惊厥亲属，16%有非热性惊厥亲属。13%的儿童惊厥表现为单侧发作或持续超过十分钟。约30%的病例中，家长在惊厥发作前未意识到孩子发烧。81%的病例中，惊厥发作前发热持续时间少于24小时。平均随访时间为28个月，范围为6至70个月。与不服用苯巴比妥的儿童相比，接受“间歇性”苯巴比妥治疗的儿童复发率无显著差异。与其他两组相比，每日服用苯巴比妥的儿童复发率显著降低。每日服用苯巴比妥的儿童中无严重复发性热性惊厥发生，而接受间歇性或不服用苯巴比妥治疗的儿童中这一比例为4.4%。家长的抵触情绪、依从性以及可逆性多动是持续服用苯巴比妥治疗方案中遇到的主要问题。
