9 Phenytoin Phenytoin has not been shown to be effective in preventing the recurrence of simple febrile seizures. Children with a history of febrile seizures were given oral diazepam or a placebo at the time of fever. A potential drawback to intermittent medication is that a seizure could occur before a fever is noticed. Adverse effects of oral diazepam include lethargy, drowsiness, and ataxia. The sedation associated with this therapy could mask evolving signs of a central nervous system infection.
Most children have an excellent prognosis.
Although there are effective therapies that could prevent the occurrence of additional simple febrile seizures, the potential adverse effects of such therapy are not commensurate with the benefit. In situations in which parental anxiety associated with febrile seizures is severe, intermittent oral diazepam at the onset of febrile illness may be effective in preventing recurrence. Antipyretics, although they may improve the comfort of the child, will not prevent febrile seizures. Based on the risks and benefits of the effective therapies, neither continuous nor intermittent anticonvulsant therapy is recommended for children with 1 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.