Convulsions hyperthermiques
In : "National Guideline Clearinghouse Disclaimer © 2000 National Guideline Clearinghouse
Date Modified: Friday, September 03, 1999 Complete Summary
Long-term treatment of the child with simple febrile seizures.
SOURCE(S):Pediatrics 1999 Jun;103(6 Pt 1):1307-9.
Les convulsions déclanchées par la fièvre sont une source importante d'inquiétude pour les parents. Il est nécessaire de leur apporter une information simple, claire et une conduite à tenir pratique lors des épidodes fébriles.
Voir Traitement le fièvre de l'enfant
L'utilisation éventuelle d'anti-épileptique est rarement nécessaire.

MAJOR RECOMMENDATIONS:

Based on the risks and benefits of the effective therapies, neither continuous nor intermittent anticonvulsant therapy is recommended for children with one or more simple febrile seizures. The American Academy of Pediatrics recognizes that recurrent episodes of febrile seizures can create anxiety in some parents and their children, and, as such, appropriate education and emotional support should be provided."

Neither continuous nor intermittent antiepileptic therapy should be given routinely to children between the ages of 6 months and 5 years who have experienced one or more simple febrile seizures, the American Academy of Pediatrics (AAP) recommends in the July issue of Pediatric Neurology.

Athough theoretical risks for simple febrile seizures include development of epilepsy, adverse effect on intelligence, death by aspiration and recurrence, the only documented adverse effect is recurrence, Dr. Patricia K. Duffner, of the Children's Hospital of Buffalo, NY, and colleagues concluded that continuous treatment with either phenobarbital or valproic acid and intermittent treatment with diazepam are effective in preventing the recurrence of simple febrile seizures." However, "the Committee determined that the potential toxicities associated with antiepileptic therapy outweigh the relatively minor risks associated with simple febrile seizures."

Noting that recurrent febrile seizures can create anxiety in some parents and children, the AAP calls for the provision of appropriate education and emotional support. When parental anxiety is severe, the AAP suggests that "intermittent oral diazepam at the onset of febrile illness may be effective in preventing recurrence." Pediatr Neurol 2000;23:11-17."

Rapporté par le Dr Méziane Aguercif
Professeur de Pédiatrie Conseiller Directeur Général Agence Nationale de Recherche en Santé (Algérie) maguercif@aol.com www.multimania.com/maguercif/ http://perso.wanadoo.fr/meziane.aguercif