EMİNE GÜLŞAH ÖZDEMİR, MUHAMMET GÜLTEKİN KUTLUK, GÖKÇEN ÖZ TUNÇER, GÜLHİS DEDA
Ankara Üniversitesi Tıp Fakültesi Mecmuası - 2023;76(4):304-309
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.
