Introduction: Febrile seizures (FS) are the most common convulsive events in early childhood, affecting 2–5% of children worldwide. While typically benign, recurrence remains a concern. Although intermittent diazepam is often used as prophylaxis, it is associated with adverse effects. Levetiracetam, a broad-spectrum antiepileptic, may offer a safer alternative. Aim of the work: To compare the efficacy and side effect profile of intermittent oral levetiracetam versus diazepam in preventing febrile seizure recurrence in children aged 6–36 months. Methodology: A randomized clinical trial was conducted at Assiut University Children's Hospital over a one-year period. A total of 109 children aged 6–36 months with a history of febrile seizures were enrolled and randomized into two groups: Group A (n=46) received oral levetiracetam (15–20 mg/kg twice daily), and Group B (n=63) received oral diazepam (0.3 mg/kg every 8 hours), both initiated at fever onset and continued for 48 hours after fever resolution. Follow-up was conducted over 12 months to assess recurrence rates, compliance, and adverse effects. Results: Although the recurrence rate of febrile seizures was lower in the levetiracetam group, the difference was not statistically significant. However, compliance was higher and adverse effects were fewer in the levetiracetam group. Common side effects in the diazepam group included sedation, behavioural disturbances, and gastrointestinal symptoms. Conclusion: Intermittent oral levetiracetam appears to be a safe and effective alternative to diazepam for febrile seizure prophylaxis, with better tolerability and parental compliance.
Kariman Hussein Tawfik (Tue,) studied this question.