Fukuyama Y, Seki T, Ohtsuka C, Miura H, Hara M
Child Neurology Institute, Tokyo, Japan.
Brain Dev. 1996 Nov-Dec;18(6):479-84. doi: 10.1016/s0387-7604(96)00066-6.
Recent studies have shown that adequate medication can prevent the recurrence of febrile seizures (FS). It has also been clarified that the vast majority of, though not all, FS patients follow a benign course. Then, questions arise as to whether or not FS should be prevented, particularly in light of the risks of side effects from drugs. Which kinds of FS can be prevented, if necessary? The guidelines presented here are aimed primarily at helping general practitioners in considering how to manage FS most appropriately. The guidelines stress that judgements should be individualized, while referring to a few specific 'warning factors'. The guidelines follow a 'laissez-faire' principle for the majority of FS cases, whereas intermittent therapy with diazepam and continuous medication with either phenobarbital or valproate are indicated in other limited cases meeting respective definite criteria.
近期研究表明,适当用药可预防热性惊厥(FS)复发。同时也已明确,尽管并非所有FS患者,但绝大多数患者病情呈良性发展。于是,就出现了是否应预防FS的问题,尤其是考虑到药物副作用风险的情况下。如有必要,哪些类型的FS可以预防呢?此处给出的指南主要旨在帮助全科医生思考如何最恰当地处理FS。指南强调,判断应个体化,同时参考一些特定的“警示因素”。对于大多数FS病例,指南遵循“放任”原则,而在其他符合各自明确标准的有限病例中,则建议使用地西泮进行间歇治疗,或使用苯巴比妥或丙戊酸进行持续用药。