A meta-analytic review of the preventive treatment of recurrences of febrile seizures☆,☆☆,★
Section snippets
Methods
A literature search of Medline was performed to find all randomized controlled studies on the prevention of febrile seizures published in English. This reference list and articles known to us before the computer search were reviewed to ascertain that all the articles were found. Forty-five studies were found; all authors read and analyzed these articles independently using a predesigned data collection sheet. Only the randomized, placebo-controlled studies were included in the final analysis.
Results
Thirty-six of the 45 articles (80%) were excluded for the following reasons: 26 studies were not adequately randomized or controlled, 8 were not efficacy trials, 1 was a review article, and 1 was a meta-analysis comparing the efficacy of phenobarbital and valproate. Nine articles met the inclusion criteria and are presented in the Table. There were four placebo-controlled studies on phenobarbital, three on diazepam, one on pyridoxine, and one on phenytoin. In one of the phenobarbital trials,
Discussion
Although different preventive therapies have been used for more than 20 years, few randomized, placebo-controlled trials on the prevention of recurrent febrile seizures exist. According to this meta-analysis, only continuously administered phenobarbital or valproate has been shown to be more effective than placebo in the prevention of febrile seizures. Phenobarbital has been widely used since the 1972 report of Faero et al.4, which showed that children receiving phenobarbital had fewer
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From the Department of Pediatrics, University of Oulu, FIN-90220 Oulu, Finland
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Reprint requests: Heikki Rantala, MD, Assistant Professor of Pediatrics, Department of Paediatrics, University of Oulu, FIN-90220 Oulu, Finland.
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9/22/81361