Study On Prevention Of Recurrent Febrile Seizures With Levetiracetam In Children

Background and objective: Febrile Seizure(FS) is the most commoncause of pediatric seizures, the rate of recurrence is high, and the incidence ofepilepsy in these children is much higher than the general population. Now,intermittent diazepam(DZP) and daily medication with phenobarbital (PB) orvalproate (VPA) are used to prevent recurrence and the effective rate is70%-80%. However, it is generally seen that their side effects outweigh likelybenefits. As one of new antiepileptic drugs(AEDs), levetiracetam(LEV) has theadvantages of novel mechanism, rapid effect, good antiepileptic efficacy andsafety. In recent years, some animal studies have demonstrated that theeffectiveness of LEV in prevention of FS is similar to VPA and PB, with slightside effect. The objective of this study is to evaluate this drug’s clinical efficacyand safety, comparing with control group, to provide a new choice of theprevention of FS.Methods:81cases were collected in the First Hospital of Jilin Universityfrom September in2010to February in2012, with approval from theirguardians, after examinations of electrolyte level of blood, routine blood test,routine urinalysis, hepatic and renal function,24-hour ambulatory electroen-cephalogram (24hAEEG). They were randomly divided into three groups, thecontrol group, low dosage group and high dosage group. When they had a feverof37.5°C or higer, only antipyretic was given in control group, while, thetreatment group took LEV tablet of20mg/kg per day and40mg/kg per day for5days respectively, antipyretic was not given until the temperature rised to38.5°C. Followed up every three months, recorded the frequency of fever andFS recurrence, medication, side effect of LEV. Every six months the24hAEEG was examed. Patients were followed up for12to18months. If the case had2afebrile seizures or1with unnormal24hAEEG, they would be diagnosedepilepsy.Results:(1) Comparison of the recurrence of FS: There were27,28and26cases in the control group, low dosage group and high dosage grouprespectively, the recurrence rates were48.1%,17.9%and15.4%, the averagetimes of recurrence were2.38±0.48,1.60±0.54and1.50±0.50per18months,there was no significant difference between two treatment groups, but therewere significant differences between two treatment groups and control. Thedifferences of recurrence of SFS and CFS between two treatment groups werenot statistically significant.(2) Comparison of the incidence of epilepsy: Thereare2,1and1cases who are diagnosed epilepsy in three groups respectively,the incidence of control group was7.4%, which was higher than the treatmentgroups (3.6%and3.8%), but the differences were not statistically significant.(3) Side effect: Only one case appeared mild excitement in low dosage group,while there were6cases who show excitement, impulse, somnolence ordizziness in high dosage group, the rates of side effect were3.6%and23.1%,and there was no significant difference between them.Conclusions:(1) LEV can effectively prevent the recurrence of FS inchildren.(2) LEV can’t reduce the incidence of epilepsy in FS patients.(3) Rateof side effect in high dosage group was higher than small, but none was serious.