Abstract
BackgroundIn previous study, we have found intermittent oral levetiracetam (LEV) can effectively prevent recurrence of febrile seizure (FS). This study aimed to analyze the effects of the preventive on the patients with frequent FS accompanied with epileptiform discharge.MethodsPatients with frequent FS were assigned to undergo Electroencephalogram (EEG). At the onset of fever, the patients who presented epileptiform discharge were orally administered with LEV with a dose of 15–30 mg/kg per day twice daily for 1 week, thereafter, the dosage was gradually reduced until totally discontinued in the second week. The seizure frequency associated with febrile events and FS recurrence rate during a 48-week follow-up were analyzed.Resultsamong the 19 patients presented epileptiform discharge on EEG, 31.58% (6 of 19) had complex FS, 68.42% (13 of 19) had simple FS. Up to 57.89% (11 of 19) had a family history of seizure disorder and 36.84% (7 of 19) had a family history of FS in first-degree relatives. 42.11% (8 of 19) happened the first FS episode at the age < 18 months. 36.84% (7/19) presented generalized spikes, 63.16% (12/19) showed focal spikes. During the 48-week follow-up period, the patients experienced 26 febrile episodes, none of them presented seizure recurrence.ConclusionIntermittent oral LEV can prevent the seizure recurrence of FS accompanied with epileptiform discharge in 48-week. However, further randomized controlled trials should be conducted.Trial registrationChiCTR-IPR-15007241; Registered 1 January 2014 - Retrospectively registered.
Highlights
In previous study, we have found intermittent oral levetiracetam (LEV) can effectively prevent recurrence of febrile seizure (FS)
FS is a benign condition in most cases and the prognosis is good generally and recurrences do not impair the prognosis in children who were neurologically normal before their first febrile seizure, FS episodes constitute a traumatic experience, it is a very frightening
Considering that the potential toxicities associated with antiepileptic therapy outweigh the relatively minor risks associated with FS, the American Academy of Pediatrics does not recommend continuous antiepileptic therapy with phenobarbital or valproic acid (VPA) and intermittent therapy with diazepam to prevent FS recurrences [4, 9]
Summary
We have found intermittent oral levetiracetam (LEV) can effectively prevent recurrence of febrile seizure (FS). FS is a benign condition in most cases and the prognosis is good generally and recurrences do not impair the prognosis in children who were neurologically normal before their first febrile seizure, FS episodes constitute a traumatic experience, it is a very frightening. During 2009 to 2011, in order to find a safe and effective therapy to prevent FS recurrences, we performed a multicenter, randomized, controlled, 48-week follow-up parallel-group outpatient study in children with FS, and verified that intermittent oral LEV can help the patients with frequent FS to reduce the recurrence of FS effectively and safely [10]
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