A meta-analytic review of the preventive treatment of recurrences of febrile seizures

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#anticonvulsants #chi-square-distribution #child #diazepam #drug-administration-schedule

A meta-analytic review of the preventive treatment of recurrences of febrile seizures

Rantala et al., 1997 | J Pediatr | Meta Analysis

Citation

Rantala H, Tarkka R, Uhari M. A meta-analytic review of the preventive treatment of recurrences of febrile seizures. J Pediatr. 1997-Dec;131(6):922-5

Abstract

OBJECTIVE: To assess the efficacy of various medications in the prevention of recurrent febrile seizures. STUDY DESIGN: A meta-analysis of all published randomized, placebo-controlled trials of the preventive treatment of febrile seizures published in English; 45 articles were found, but only 9 trials were randomized and placebo-controlled--4 using phenobarbital; 3, diazepam; 1, pyridoxine; and 1, phenytoin. In one of the phenobarbital trials, valproate was also compared with placebo. RESULTS: The risk of recurrences was significantly lower in children receiving continuous phenobarbital therapy than placebo (odds ratio 0.54, 95% confidence intervals 0.33 to 0.90, p = 0.017). The odds ratio for recurrences in the valproate group was 0.09, 95% CI 0.01 to 0.78, p = 0.011. No difference in the risk was found for recurrences between children receiving intermittent diazepam and placebo (odds ratio 0.81, 95% CI 0.54 to 1.22, p = 0.31). The risk for recurrences in children receiving pyridoxine or phenytoin did not differ from the risk among children receiving placebo. Four children would have to be treated with valproate (95% CI 2 to 11) or eight children would have to be treated with phenobarbital (95% CI 5 to 27), continuously, to prevent one febrile seizure. CONCLUSIONS: Because both agents found to be effective in prevention of recurrent febrile seizures have known adverse effects, prophylaxis of febrile seizures cannot be recommended.

Key Findings

The risk of recurrences was significantly lower in children receiving continuous phenobarbital therapy than placebo (odds ratio 0.54, 95% confidence intervals 0.33 to 0.90, p = 0.017). The odds ratio for recurrences in the valproate group was 0.09, 95% CI 0.01 to 0.78, p = 0.011. No difference in the risk was found for recurrences between children receiving intermittent diazepam and placebo (odds ratio 0.81, 95% CI 0.54 to 1.22, p = 0.31). The risk for recurrences in children receiving pyridoxin

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 9
Age Range See abstract
Condition See abstract

MeSH Terms

  • Anticonvulsants
  • Chi-Square Distribution
  • Child
  • Diazepam
  • Drug Administration Schedule
  • Fever
  • Humans
  • Odds Ratio
  • Phenobarbital
  • Phenytoin
  • Pyridoxine
  • Randomized Controlled Trials as Topic
  • Recurrence
  • Risk Assessment
  • Seizures, Febrile
  • Valproic Acid

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Comparative Study, Journal Article, Meta-Analysis
  • Vertical: vitamin-b6

Provenance

  • PMID: 9427902
  • DOI: (not available)
  • PMCID: Not in PMC
  • Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09