Medication Summary
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. In situations in which a child tends to have febrile seizures with frequent illnesses, and seizures tend to occur after the onset/recognition of fever, oral diazepam can be considered for the duration of the fever.
Benzodiazepines
Class Summary
These agents have antiseizure activity and act rapidly in acute seizures.
Diazepam (Diastat Pediatric, Valium)
Oral diazepam can decrease number of subsequent febrile seizures when given with each febrile episode. Many practitioners will prescribe rectal diazepam, particularly to patients who have had prolonged febrile seizures, in order to prevent future episodes of febrile status epilepticus. By increasing activity of GABA, a major inhibitory neurotransmitter, diazepam depresses all levels of CNS, including limbic and reticular formation.
A study reported in New England Journal of Medicine gave oral diazepam 0.33 mg/kg per dose, every 8 hours throughout the febrile illness, until the child was afebrile for 24 hours. However, this dosage was frequently associated with side effects such as imbalance, lethargy, and irritability.
