Abstract
Background and Objectives: Febrile seizure is the most common seizure disorder occurring in childhood. A simple febrile seizure is a generalized seizure but it is brief and occurs often once during a 24 hours period. Unfortunately in %15-20 of patient's recurrence of seizure occurs. Here we assessed the effectiveness and safety of intramuscular or oral Phenobarbital on preventing the further seizure in acute phase of a febrile illness.
Method & Materials: In this clinical trial, healthy children with diagnosis of simple febrile seizure, who were admitted to the pediatric neurology unit of Tabriz Children Hospital were included three groups; case group (one) (intramuscular Phenobarbital), case group(two) oral Phenobarbital, and controls. Fifty three patients in group one received, intramuscular Phenobarbital initial dose of 10mg/kg (up to 200 mg), fifty four patient received oral Phenobarbital initial dose of 15mg/kg (up to 300 mg), and 12 hours later 5 mg/kg/d orally until the fever had subsided, in both groups. Fifty nine patients observed as controls. Rate of recurrence of seizure was compared in two groups, during the acute phase of disease.
Results: There was no significant difference in sex, age, etiology, degree of fever, history of neonatal admission, family history of febrile seizure and epilepsy between groups. In control group recurrence of seizure occurred in 11 patients (18.6%) while in case groups happened in 3 patient (2.8%), including one (1.8%) in case group one and 2 patients (3.7%) in case group two, and the differences was significant (P=0.008). However there was no significant difference between oral and intramuscular. Blood level of Phenobarbital, 2 hrs after loading dose in both administration groups was in therapeutic level and the difference between Phenobarbital levels was not significant between two intervention groups. There was no serious side effect of Phenobarbital in case groups.
Conclusion: The results of this study indicate that Phenobarbital can prevents the recurrence of seizure in children with simple febrile seizure when it is administered in its acute phase of same febrile illness.