Acetaminophen May Decrease Recurrence of Febrile Seizures in Children Within the Same Episode

By Lynn Hetzler via Multibriefs

When administered soon after the initial seizure, rectal acetaminophen can decrease the rates of second febrile seizure in pediatric patients during the course of the same febrile illness, according to a new study. The researchers also found no association between acetaminophen use in the setting of febrile seizure (FS) and increased serious adverse events or neurologic sequelae.

Febrile seizures are the most common type of seizures seen in children. Many children have multiple convulsions during the course of a single febrile illness.

While febrile seizures frequently occur, and multiple seizures within febrile events are common, there is a paucity of data on the prevention of recurrent seizures — especially in the pediatric population.

Practitioners frequently administer acetaminophen to decrease discomfort associated with fevers because the antipyretic effects of acetaminophen are well established. Prior to this study, though, researchers had not yet studied the relationship between antipyretics and the recurrence of febrile seizures.

The researchers performed a randomized, controlled trial to evaluate the use of acetaminophen to reduce the occurrence of febrile seizures within a single febrile episode. They also described the safety of using acetaminophen to reduce FSs. The results of the study suggest that pediatric patients who received rectal acetaminophen were less likely to experience a second FS during the same febrile event compared with those pediatric patients who did not receive acetaminophen.

The results of the study suggest rectal acetaminophen could effectively minimize the recurrence of a second FS in children without increasing rates of serious adverse events. No participants experienced, hypotension, anaphylaxis, or other serious adverse reactions associated with acetaminophen treatment for febrile seizures.

Using Acetaminophen to Reduce Febrile Seizures in the Pediatric Population

The researchers enrolled 423 pediatric patients into the study. The participants were between the ages of 6 and 60 months. Each presented with seizures in the setting of a fever at or greater than 38 degrees Celsius to a Japanese pediatric emergency department.

The scientists randomly assigned 229 patients to the test group, who received 10 mg/kg rectal acetaminophen right away and every 6 hours for up to 24 hours if they continued to be febrile, or to the control group who received no antipyretics. The researchers excluded patients who had neurologic comorbidities, who had already experienced more than two seizures during the current febrile event, who had a seizure lasting more than 15 minutes, and those who received antihistamines or diazepam.

Sixty-eight of all the participants (16 percent) experienced a recurrent seizure. Regardless of their age, the participants who received rectal administration of acetaminophen were significantly less likely to experience a second seizure than were those who did not receive the antipyretic, at 9.1 percent and 23.5 percent respectively.

The difference was most pronounced in participants aged 22 to 60 months who receive rectal acetaminophen than in those of the same age that did not, at 4.1 percent and 22.6 percent respectively. Shorter initial seizure duration and younger age and were significantly associated with seizure recurrence. None of the pediatric participants experienced hypotension, hypothermia, neurologic sequelae, anaphylaxis or other serious complications.

Study limitations include potential discrepancies in accuracy of body temperature monitoring, as the route of measurement was not clear.

Lynn Hetzler has been a freelance writer for more than 15 years. She has extensive experience in a variety of specialties, including transplantation, oncology, fertility, negligible senescence, laboratory science, addiction, general research and more. Lynn specializes in creating informative and engaging medical content for readers of all levels, from patients to researchers and everyone in between.