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February 1979

Continuous Phenobarbital Treatment After a 'Simple Febrile Convulsion'

Author Affiliations

Samuel Livingston Epilepsy Diagnostic and Treatment Center 1039 St Paul St Baltimore, MD 21202

Am J Dis Child. 1979;133(2):221-222. doi:10.1001/archpedi.1979.02130020113029

Sir.—We would like to comment on the article, "Continuous Phenobarbital Treatment After a 'Simple Febrile Convulsion,'" in the Journal (132:87, 1978) in which Pollack recommended daily anticonvulsant therapy on the basis of his impression that it (1) reduces the recurrence rate of simple febrile convulsions (SFCs), (2) precludes the development of "febrile status epilepticus," and (3) diminishes the incidence of subsequent epilepsy.

Pollack cited two reports1.2 that demonstrated the efficacy of phenobarbital in preventing the recurrence of "febrile seizures"; however, the results of these investigations cannot be summarily applied to SFCs. The study by Faero et al1 has been criticized,3 primarily because it consisted of patients with different types of "febrile convulsions"—at least 25% had prolonged or focal seizures or both—rather than a homogeneous series of subjects with SFCs, and also because of its brevity (six months). In addition, Heckmatt et al4 duplicated this study,

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