Intermittent Prophylactic Rectal Diazepam Treatment in Children with Febrile Seizure

Year 2023, Volume: 76 Issue: 4, 304 - 309, 05.04.2024

Emine Gülşah Özdemir Muhammet Gültekin Kutluk , Gökçen Öz Tunçer , Gülhis Deda

Abstract

Objectives: Febrile seizure (FS) is the most common neurological disorder in childhood. Intermittent rectal diazepam (DZP) prophylaxis seems to prevent recurrence, however, there remains ongoing discussion regarding its ability to prevent epilepsy. This study aimed to analyze the outcome of intermittent prophylactic rectal DZP treatment on both recurrence and subsequent epilepsy.

Materials and Methods: A total of 229 children with FS and given intermittent rectal DZP prophylaxis between 1 January 2005 and 1 December 2013 were included. Data regarding demographics, clinical characteristics, recurrence of FS, and subsequent epilepsy after intermittent rectal DZP prophylaxis were retrospectively analyzed.

Results: Of 229 patients, 57 (24.9%) patients experienced one or more recurrence. Girls had a higher recurrence rate (36.4% vs. 17.7%) (p=0.002). Patients with complex seizures had a higher recurrence rate (38.6% vs. 20.3%) (p=0.006). Epilepsy occurred in 11.4% of patients. Patients with complex seizures had a higher rate of epilepsy (22.8% vs. 7.6%) (p=0.002). Epilepsy did not occur in patients without recurrence, while the rate of epilepsy is 4.8% in patients with one recurrence, 42.1% in those with two recurrences, and 100% in those with three or more recurrences (p<0.001). The rate of epilepsy increased as the number of recurrences increased after prophylactic rectal DZP treatment.

Conclusion: It is a remarkable finding that as the number of recurrences decreased, the rate of epilepsy also decreased, and none of the patients without recurrence experienced epilepsy. Hovewer, large-scale prospective studies are needed to make a conclusion about the preventing effect of DZP prophlaxis on subsequent epilepsy.

Key Words: Febrile Seizure, Epilepsy, Intermittent Rectal Diazepam, Prophylaxis, Children

Keywords

Febrile Seizure , Epilepsy , Intermittent Rectal Diazepam , Prophylaxis , Children

Ethical Statement

Ethics Committee Approval: The study protocol was approved by the Non-Interventional Clinical Researches Ethics Board of Ankara University (17-738-14, date: 27.10.2014). Informed Consent: Written informed consent was provided by the patients’ parents and by patients aged >10 years. Peer-review: Externally peer-reviewed

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Febril Konvülziyon ile Takipli Çocuklarda Aralıklı Profilaktik Rektal Diazepam Tedavisi

Abstract

Amaç: Febril konvülziyon (FK) çocukluk çağında en sık görülen nörolojik bozukluktur. Aralıklı rektal diazepam (DZP) profilaksisi rekürrensi önlediğine dair çalışmalar mevcut olup epilepsi gelişmini önlemesi konusunda tartışmalar devam etmektedir. Bu çalışmada aralıklı profilaktik rektal DZP tedavisinin rekürrens ve epilepsi gelişimi üzerindeki sonuçlarını analiz etmek amaçlanmıştır.

Gereç ve Yöntem: 1 Ocak 2005 ile 1 Aralık 2013 tarihleri arasında aralıklı rektal DZP profilaksisi uygulanan FK’li toplam 229 çocuk çalışmaya dahil edildi. Hastaların demografik özellikleri, klinik özellikleri, aralıklı rektal DZP profilaksisi sonrası rekürrens ve epilepsi gelişimi ile ilgili veriler retrospektif olarak analiz edildi.

Bulgular: İki yüz yirmi dokuz hastanın 57’sinde (%24,9) bir veya daha fazla rekürrens görüldü. Kızlarda rekürrens oranı erkeklerden daha yüksekti (%36,4 vs. %17,7) (p=0,002). Komplike nöbetleri olan hastalarda rekürrens oranı daha yüksekti (%38,6 vs. %20,3) (p=0,006). Hastaların %11,4’ündeepilepsi geliştiği görüldü. Komplike nöbetleri olan hastalarda epilepsi oranı daha yüksekti (%22,8 vs. %7,6) (p=0,002). Rekürrens olmayan hastalarda epilepsi görülmezken, tek rekürrens olanlarda %4,8, iki rekürrens olanlarda %42,1, üç ve daha fazla rekürrens olanlarda ise %100 oranında epilepsi geliştiği görüldü (p<0,001). Profilaktik rektal DZP tedavisi sonrası rekürrens sayısı arttıkça epilepsi gelişme riskinin arttığı görüldü.

Sonuç: Rekürrens sayısı azaldıkça epilepsi görülme sıklığının azalması ve rekürrens olmayan hastaların hiçbirinde epilepsi görülmemesi, dikkat çekici bir bulgu olarak göze çarpmaktadır. Ancak rektal DZP proflaksisinin epilepsi gelişimi üzerine kesin etkisinin anlaşılabilmesi için geniş ölçekli prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Febril Konvülziyon, Epilepsi, Aralıklı Rektal Diazepam, Profilaksi, Çocuk

Keywords

Febril Konvülziyon , Epilepsi , Aralıklı Rektal Diazepam , Profilaksi , Çocuk

Ethical Statement

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