Sir.—In this present era of frequent excessive laboratory procedures and overtreatment, it is indeed comforting to have Dr Gellis in his article in the Journal (132:87-89,1978) favoring the right of the individual pediatrician to decide his own course of therapy in the controversial phenobarbital treatment after a "simple febrile convulsion." Dr Pollack in the same article advises that continuous treatment is indicated after the first febrile seizure. Dr Livingston1.2 does not recommend treating febrile seizures prophylactically. He had found that febrile convulsions do not occur more than four times a year. Beginning continuous treatment after the second seizure, or if the child has an abnormal history, or the findings Dr Gellis enumerates, is indicated.
Dr Pollack's study shows that 50% of the pediatricians recommend phenobarbital administration with the onset of febrile illness. I emphasize beginning phenobarbital whenever there is a suspicion of illness, rather than waiting until a
WILLIAM F. SCHNITZKER. 'Simple Febrile Convulsion'. Am J Dis Child. 1978;132(7):724–725. doi:10.1001/archpedi.1978.02120320084028