Oral Diazepam in Febrile Seizures Following Acellular Pertussis Vaccination

Document Type : Original Article

Authors

1 Department of Pediatric Neurology and Child Growth and Development Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Febrile seizure is the most common type of seizures among children, which is a terrible and frightening experience for parents who are concerned about its recurrence. The aim of this study was to evaluate the effect of diazepam on preventing the recurrence of febrile seizure following acellular pertussis vaccination. Materials and Methods: In this clinical trial, 121 children with a history of febrile seizure that required the pertussis vaccination were enrolled and divided into two groups; the first group was treated with oral diazepam for 48 h after vaccine injection and the control group received antipyretics only if fever occurred after the vaccination and used rectal diazepam for controlling seizure if a seizure occurred. The incidence of fever and seizure after the injection of the vaccine and incidence of febrile seizure were compared. Results: Nearly, 85.7% in the oral diazepam group and 87.9% in the rectal diazepam group had fever after receiving the pertussis vaccine, but the incidence of fever was not significantly different between the groups. Seven children (12.06%) in the rectal diazepam group had a seizure after pertussis vaccination, and none of the children in the oral diazepam group had a seizure after receiving the vaccine at 18 months of age. This difference was significant. Conclusion: Prophylaxis with diazepam administration in children with a history of febrile seizure can prevent recurrence of febrile seizure after pertussis vaccination.

Keywords

1.
Waruiru C, Appleton R. Febrile seizures: An update. Arch Dis Child 2004;89:751-6.  Back to cited text no. 1
    
2.
Shinnar S, Glauser TA. Febrile seizures. J Child Neurol 2002;17 Suppl 1:S44-52.  Back to cited text no. 2
    
3.
Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr 2008;167:17-27.  Back to cited text no. 3
    
4.
Offringa M, Kroes AC, Derksen-Lubsen G. Viral infections in febrile seizures. J Pediatr 1990;117:510-1.  Back to cited text no. 4
    
5.
Baumer JH; “Paediatric Accident and Emergency Research Group”. Evidence based guideline for post-seizure management in children presenting acutely to secondary care. Arch Dis Child 2004;89:278-80.  Back to cited text no. 5
    
6.
Camfield PR, Camfield CS, Shapiro SH, Cummings C. The first febrile seizure – Antipyretic instruction plus either phenobarbital or placebo to prevent recurrence. J Pediatr 1980;97:16-21.  Back to cited text no. 6
    
7.
van Esch A, Steyerberg EW, van Duijn CM, Offringa M, Derksen-Lubsen G, van Steensel-Moll HA, et al. Prediction of febrile seizures in siblings: A practical approach. Eur J Pediatr 1998;157:340-4.  Back to cited text no. 7
    
8.
Knudsen FU. Febrile seizures: Treatment and prognosis. Epilepsia 2000;41:2-9.  Back to cited text no. 8
    
9.
Rosman NP, Colton T, Labazzo J, Gilbert PL, Gardella NB, Kaye EM, et al. A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures. N Engl J Med 1993;329:79-84.  Back to cited text no. 9
    
10.
Baumann RJ, Duffner PK. Treatment of children with simple febrile seizures: The AAP practice parameter. American Academy of Pediatrics. Pediatr Neurol 2000;23:11-7.  Back to cited text no. 10
    
11.
Rantala H, Tarkka R, Uhari M. A meta-analytic review of the preventive treatment of recurrences of febrile seizures. J Pediatr 1997;131:922-5.  Back to cited text no. 11
    
12.
Hinman AR, Koplan JP. Pertussis and pertussis vaccine. Reanalysis of benefits, risks, and costs. JAMA 1984;251:3109-13.  Back to cited text no. 12
    
13.
Cody CL, Baraff LJ, Cherry JD, Marcy SM, Manclark CR. Nature and rates of adverse reactions associated with DTP and DT immunizations in infants and children. Pediatrics 1981;68:650-60.  Back to cited text no. 13
    
14.
Taghavi Ardekani A, Talebian A. Evaluation of the complications of triple vaccine in Kashan in 1999. KAUMS J (FEYZ) 2001;5:33-7.  Back to cited text no. 14
    
15.
Zarei S, Jeddi-Tehrani M, Mehdi Akhondi M, Zeraati H, Ferydonfar AA, Nasernia J, et al. Immunogenicity and reactogenicity of two diphtheria-tetanus-whole cell pertussis vaccines in Iranian pre-school children, a randomized controlled trial. Hum Vaccin Immunother 2013;9:1316-22.  Back to cited text no. 15
    
16.
Walker AM, Jick H, Perera DR, Knauss TA, Thompson RS. Neurologic events following diphtheria-tetanus-pertussis immunization. Pediatrics 1988;81:345-9.  Back to cited text no. 16
    
17.
Griffin MR, Ray WA, Mortimer EA, Fenichel GM, Schaffner W. Risk of seizures and encephalopathy after immunization with the diphtheria-tetanus-pertussis vaccine. JAMA 1990;263:1641-5.  Back to cited text no. 17
    
18.
IBM Corp. Released 2013. IBM SPSS Statistics for Windows. Version 22.0. Armonk, New York: IBM Corp; 2013.  Back to cited text no. 18
    
19.
Fallah R, Akhavan Karbasi S, Golestan M, Islami Z, Shajari A, Mir-Naseri F. A follow up study of admitted febrile seizure patients with respect to recurrence of febrile or afebrile seizures. SSU J 2009;16:46-55.  Back to cited text no. 19
    
20.
Barlow WE, Davis RL, Glasser JW, Rhodes PH, Thompson RS, Mullooly JP, et al. The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. N Engl J Med 2001;345:656-61.  Back to cited text no. 20
    
21.
Vestergaard M, Hviid A, Madsen KM, Wohlfahrt J, Thorsen P, Schendel D, et al. MMR vaccination and febrile seizures: Evaluation of susceptible subgroups and long-term prognosis. JAMA 2004;292:351-7.  Back to cited text no. 21
    
22.
Shinefield H, Black S, Digilio L, Reisinger K, Blatter M, Gress JO, et al. Evaluation of a quadrivalent measles, mumps, rubella and varicella vaccine in healthy children. Pediatr Infect Dis J 2005;24:665-9.  Back to cited text no. 22
    
23.
Klein NP, Fireman B, Yih WK, Lewis E, Kulldorff M, Ray P, et al. Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures. Pediatrics 2010;126:e1-8.  Back to cited text no. 23
    
24.
Baumann RJ. Technical report: Treatment of the child with simple febrile seizures. Pediatrics 1999;103:e86.  Back to cited text no. 24
    
25.
Hohjo M, Miura H, Minagawa K, Mizuno S, Shirai H. A clinical study on the effectiveness of intermittent therapy using oral diazepam syrups for the prevention of recurrent febrile convulsions: A preliminary report. No To Hattatsu 1986;18:234-5.  Back to cited text no. 25
    
26.
Beyraghi N, Hatamian B, Vesal A, Tonekaboni S. Comparison between diazepam and phenobarbital in prevention of febrile seizure: Clinical trial. Iran J Child Neurol 2008;2:37-40.  Back to cited text no. 26