Profilaxia intermitente na convulsão febril com diazepam via oral

Guerreiro, Marilisa M.; Costa, Maristela; Bellomo, M. Angela; Sabino, Sílvia H.; Silva, Ednéa A.; Scotoni, Anna E.

doi:10.1590/S0004-282X1992000200005

Resumos

Apresentamos a profilaxia intermitente com diazepam via oral como opção de tratamento para convulsão febril. Justificamos essa proposta diante dos importantes efeitos colaterais que ocorrem com as duas medicações classicamente usadas na profilaxia contínua (fenobarbital e valproato). Foram tratados 19 pacientes. Obtivemos resultados favoráveis, pois apenas um caso apresentou recorrência de convulsão febril em vigência de dose adequada do diazepam. Houve efeitos colaterais transitórios em 36,8% da nossa casuística.

convulsão febril; profilaxia medicamentosa intermitente; diazepam (via oral)

Intermittent prophylaxis with oral diazepam is presented as an optional treatment for febrile seizures. This proposition is justified by the severe side effects of the currently used chronic anticonvulsant drug therapy in febrile seizures (phenobarbital and valproate). Nineteen patients aged between 3 months and 5 years were treated. They had either simple) or complex febrile seizures. Sixteen patients, had at least one prognostic factor for recurrence of febrile seizures: first febrile seizure before 15 months of age, positive family history for epilepsy or febrile seizures, occurrence of a complex febrile seizure or abnormal neurological examination. Three patients had none, (cases 8, 12 and 13). We recommended 2.5mg b.i.d. for children younger than 12 months, 5mg b.i.d. for children older than 12 months and younger than 3 years, and 7.5 b.i.d. for children older than 3 years. The results showed that only one patient had febrile convulsions while taking adequate diazepam dosage. Transient side effects occurred in 36.8% of the cases.

febrile seizures; intermittent drug prophylaxis; diazepam (oral administration)

Marilisa M. Guerreiro^I; Maristela Costa^II; M. Angela Bellomo^II; Sílvia H. Sabino^II; Ednéa A. Silva^III; Anna E. Scotoni^III

^IProfessor Assistente. Trabalho realizado na Disciplina de Neurologia Infantil do Departamento de Neurologia da Faculdade de Ciências Médicas (FCM) da Universidade Estadual de Campinas (UNICAMP), São Paulo

^IIAluna do 6º ano. Trabalho realizado na Disciplina de Neurologia Infantil do Departamento de Neurologia da Faculdade de Ciências Médicas (FCM) da Universidade Estadual de Campinas (UNICAMP), São Paulo

^IIIPós-Graduanda. Trabalho realizado na Disciplina de Neurologia Infantil do Departamento de Neurologia da Faculdade de Ciências Médicas (FCM) da Universidade Estadual de Campinas (UNICAMP), São Paulo

RESUMO

Apresentamos a profilaxia intermitente com diazepam via oral como opção de tratamento para convulsão febril. Justificamos essa proposta diante dos importantes efeitos colaterais que ocorrem com as duas medicações classicamente usadas na profilaxia contínua (fenobarbital e valproato). Foram tratados 19 pacientes. Obtivemos resultados favoráveis, pois apenas um caso apresentou recorrência de convulsão febril em vigência de dose adequada do diazepam. Houve efeitos colaterais transitórios em 36,8% da nossa casuística.

Palavras-chave: convulsão febril, profilaxia medicamentosa intermitente, diazepam (via oral).

SUMMARY

Intermittent prophylaxis with oral diazepam is presented as an optional treatment for febrile seizures. This proposition is justified by the severe side effects of the currently used chronic anticonvulsant drug therapy in febrile seizures (phenobarbital and valproate). Nineteen patients aged between 3 months and 5 years were treated. They had either simple) or complex febrile seizures. Sixteen patients, had at least one prognostic factor for recurrence of febrile seizures: first febrile seizure before 15 months of age, positive family history for epilepsy or febrile seizures, occurrence of a complex febrile seizure or abnormal neurological examination. Three patients had none, (cases 8, 12 and 13). We recommended 2.5mg b.i.d. for children younger than 12 months, 5mg b.i.d. for children older than 12 months and younger than 3 years, and 7.5 b.i.d. for children older than 3 years. The results showed that only one patient had febrile convulsions while taking adequate diazepam dosage. Transient side effects occurred in 36.8% of the cases.

Key words: febrile seizures, intermittent drug prophylaxis, diazepam (oral administration).

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Dra. Marilisa M. Guerreiro Departamento de Neurologia/FCM/UNICAMP - Caixa Postal 6111 - 13081 Campinas SP - Brasil.

1. Addy DP. Prophylaxis and febrile convulsions. Arch Dis Child 1981, 56:81-83.
2. Antony JH. Drug treament of recurrent febrile seizures. AJDC 1984, 138:507-508.
3. Antony JH, Hawke SHB. Phenobarbital compared with carbamazepine in prevention of recurrent febrile convulsions. Am J Dis Child 1983, 137:892-895.
4. Dianese G. Prophylaxis of febrile convulsions: searching for the best. Arch Dis Child 1986, 61:621-622.
5. Forwell JR, Lee YJ, Hirtz DG, Sulzbacher SI, Ellenberg JH, Nelson KB. Phenobarbital for febrile seizures: effects on intelligence and on seizure recurrence. N Engl J Med 1990, 322:364-369.
6. Freeman JM. Febrile seizures: a consensus of their significance, evaluation, and treatment. Pediatrics 1980, 66:1009-1012.
7. Hauser WA. The natural history of febrile seizures. In Nelson KB, Ellenberg JH (eds) : Febrile Seizures. New York: Raven Press, 1981, p 5.
8. Knudsen FU. Effective short-term diazepam prophylaxis in febrile convulsions. J Pediatr 1985, 106:487-490.
9. Knudsen FU. Recurrence risk after first febrile seizure and effect of short-term diazepam prophylaxis. Arch Dis Child 1985, 60:1045-1049.
10. Knudsen FU, Vestermark S. Prophylatic diazepam or phenobarbitone in febrile convulsions: a prospective, controlled study. Arch Dis Child 1978, 53:660-663.
11. Millichap JG. The definition of febrile seizures. In Nelson KB, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 1.
12. Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures. Pediatrics 1978, 61:720-727.
13. Nelson KB, Ellenberg JH. The role of recurrences in determining outcome in children with febrile seizures. In Nelson KB, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 19.
14. Nelson KB, Ellenberg JH. Prenatal and perinatal antecedents of febrile seizures. Ann Neurol 1990, 27:127-131.
15. Pilgaard S, Hansen FJ, Perregaard P. Prophylaxis against febrile convulsions with phenobarbital. Acta Pediat Scand 1981, 70:67-71.
16. Porter RJ. Pharmacokinetic basis of intermittent and chronic anticonvulsant drug therapy in febrile seizures. In Nelson KB, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 107.
17. Thorn I. Prevention of recurrent febrile seizures: intermittent prophylaxis with diazepam compared with continuous treatment with phenobarbital. In Nelson K B, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 119.
18. Wallace SJ. Prevention of recurrent febrile seizures using continuous prophylaxis: sodium valproate compared with phenobarbital. In Nelson KB, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 135.

Profilaxia intermitente na convulsão febril com diazepam via oral

Intermittent prophylaxis in febrile seizures with oral diazepam

Datas de Publicação

Publicação nesta coleção
22 Fev 2011
Data do Fascículo
Jun 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Addy DP. Prophylaxis and febrile convulsions. Arch Dis Child 1981, 56:81-83.

[2] 2. Antony JH. Drug treament of recurrent febrile seizures. AJDC 1984, 138:507-508.

[3] 3. Antony JH, Hawke SHB. Phenobarbital compared with carbamazepine in prevention of recurrent febrile convulsions. Am J Dis Child 1983, 137:892-895.

[4] 4. Dianese G. Prophylaxis of febrile convulsions: searching for the best. Arch Dis Child 1986, 61:621-622.

[5] 5. Forwell JR, Lee YJ, Hirtz DG, Sulzbacher SI, Ellenberg JH, Nelson KB. Phenobarbital for febrile seizures: effects on intelligence and on seizure recurrence. N Engl J Med 1990, 322:364-369.

[6] 6. Freeman JM. Febrile seizures: a consensus of their significance, evaluation, and treatment. Pediatrics 1980, 66:1009-1012.

[7] 7. Hauser WA. The natural history of febrile seizures. In Nelson KB, Ellenberg JH (eds) : Febrile Seizures. New York: Raven Press, 1981, p 5.

[8] 8. Knudsen FU. Effective short-term diazepam prophylaxis in febrile convulsions. J Pediatr 1985, 106:487-490.

[9] 9. Knudsen FU. Recurrence risk after first febrile seizure and effect of short-term diazepam prophylaxis. Arch Dis Child 1985, 60:1045-1049.

[10] 10. Knudsen FU, Vestermark S. Prophylatic diazepam or phenobarbitone in febrile convulsions: a prospective, controlled study. Arch Dis Child 1978, 53:660-663.

[11] 11. Millichap JG. The definition of febrile seizures. In Nelson KB, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 1.

[12] 12. Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures. Pediatrics 1978, 61:720-727.

[13] 13. Nelson KB, Ellenberg JH. The role of recurrences in determining outcome in children with febrile seizures. In Nelson KB, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 19.

[14] 14. Nelson KB, Ellenberg JH. Prenatal and perinatal antecedents of febrile seizures. Ann Neurol 1990, 27:127-131.

[15] 15. Pilgaard S, Hansen FJ, Perregaard P. Prophylaxis against febrile convulsions with phenobarbital. Acta Pediat Scand 1981, 70:67-71.

[16] 16. Porter RJ. Pharmacokinetic basis of intermittent and chronic anticonvulsant drug therapy in febrile seizures. In Nelson KB, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 107.

[17] 17. Thorn I. Prevention of recurrent febrile seizures: intermittent prophylaxis with diazepam compared with continuous treatment with phenobarbital. In Nelson K B, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 119.

[18] 18. Wallace SJ. Prevention of recurrent febrile seizures using continuous prophylaxis: sodium valproate compared with phenobarbital. In Nelson KB, Ellenberg JH (eds): Febrile Seizures. New York: Raven Press, 1981, p 135.