Prophylactic diazepam or phenobarbitone in febrile convulsions: a prospective, controlled study.

Abstract

After their 1st episode of febrile convulsions, 195 previously healthy children, aged 6-30 mo., were given either diazepam or phenobarbitone for a yr. Each child was assigned at random to 1 of the 2 medications. Children admitted on even days were given a suppository containing 5 mg diazepam every 8 h. when the rectal temperature was .gtoreq. 38.5.degree. C. Children admitted on odd days were given treatment with phenobarbiton, 3.5 .+-. 1 mg per kg/day; 156 children completed treatment and outpaitent control for a yr, 83 in the diazepam and 73 in the phenobarbitone group. The rate of recurrence was independent of the prophylactic and 15-16% of the children in both groups had new febrile convulsions within a yr. The recurrence rate after 6 mo. was also similar, 11% in the diazepam group and 9% in the phenobarbitone group. New convulsions were of similar duration and severity in both groups. In both groups 6% of all febrile episodes led to new convulsions. Long-term treatment with phenobarbitone thus offered no advantage over intermittent diazepam.