What are the treatment options for pediatric febrile seizures?

Updated: Nov 09, 2018
  • Author: Robert J Baumann, MD; Chief Editor: Amy Kao, MD  more...
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Answer

On the basis of risk/benefit analysis, neither long-term nor intermittent anticonvulsant therapy is indicated for children who have experienced 1 or more simple febrile seizures.

  • Continuous therapy with phenobarbital or valproate decreases the occurrence of subsequent febrile seizures.

    • Both therapies confer significant risks and potential adverse effects, whereas additional simple febrile seizures have no proven risk.

    • These medications are not recommended, since the potential benefits do not outweigh the potential risks.

  • No evidence suggests that any therapy administered after a first simple seizure will reduce the risk of a subsequent afebrile seizure or the risk of recurrent afebrile seizures (ie, epilepsy).

  • Oral diazepam can reduce the risk of subsequent febrile seizures. Because it is intermittent, this therapy probably has the fewest adverse effects. If preventing subsequent febrile seizures is essential, this would be the treatment of choice. [4]

  • Although it does not prevent simple febrile seizures, antipyretic therapy is desirable for other reasons, for instance comfort.


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