Comparative Study of Intermittent Benzodiazepine Prophylaxis versus Paracetamol Alone for Preventing Recurrence of Febrile Seizures
Objective: To compare the effectiveness of intermittent benzodiazepine therapy with paracetamol alone in preventing the recurrence of febrile seizures and to study the clinical profile of children with recurrent febrile seizures.
Method of Study: This is a prospective study on 93 neurologically normal children aged from 6 months to 4 years, admitted with a history of febrile seizures during the study period, January -September 2015. Children with history of afebrile seizures and infection of nervous system were excluded. 45 children were prescribed only paracetamol when febrile (assigned as Group 1) and age matched 48 children were given benzodiazepine prophylaxis for initial three days of fever during each febrile episodealong with paracetamol to control fever (assigned as group 2). Oral clobazam and oral diazepam at appropriate doses were used for intermittent prophylaxis. All the patients were followed up for 12 months, for recurrence of seizures during fever.
Results: Among the 93 children included in the study, 48 were males and 45 were females. 43.8% had positive family history with first degree relative affected in 19.1% and second degree relative in 24.6%. Family history of epilepsy is present in 9.5%.The most common etiology for fever was viral infection (57.5%). Atypical febrile seizures occurred in 28.7%. Multiple episodes of seizure during a febrile episode were also reported (20.5%). 8.2% children had focal seizures. The recurrence of febrile seizure was found in total of 52% children. Recurrence was maximum (31.5%) in the age group of 1-2 years. Among those with recurrence all had typical febrile seizure except 4 children. A recurrence rate of 56% and 53% was noted in group 1 and group2 respectively, which was not statistically significant.
Conclusion: We conclude that administration of benzodiazepines along with paracetamol is not superior in efficacy to paracetamol alone in preventing the recurrence of febrile seizure.