***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The results of the initial North American trial of the nonionic , water-soluble contrast medium iopamidol for lumbosacral myelography are reported . The iopamidol was easily visualized by fluoroscopy during introduction , and the radiographic quality of all 12 conventional myelographic examinations was excellent . The diagnoses were herniated nucleus pulposus ( seven ) , traumatic dislocation ( one ) , metastasis ( one ) , and normal ( three ) . One patient had a repeat myelogram with a different hydrosoluble contrast medium 2 months after his iopamidol examination and surgery and showed no radiographic evidence of arachnoiditis . The adverse reactions were all mild and transient : headache ( four cases ) , nausea ( two ) , and leg pain ( one ) . There were no diaphoresis , fever , seizures , hallucinations , agitation , or vital sign changes . Electrocardiography , hematology , and blood chemistries were all normal . In two patients , electroencephalogram changes , three to four bursts of diffuse intermittent rhythmic delta activity with no spiking , were present at 6 hr with return to normal at 24 hr OBJECTIVE To evaluate the efficacy of different antipyretic agents and their highest recommended doses for preventing febrile seizures . DESIGN R and omized , placebo-controlled , double-blind trial . SETTING Five hospitals , each working as the only pediatric hospital in its region . PARTICIPANTS A total of 231 children who experienced their first febrile seizure between January 1 , 1997 , and December 31 , 2003 . The children were observed for 2 years . INTERVENTIONS All febrile episodes during follow-up were treated first with either rectal diclofenac or placebo . After 8 hours , treatment was continued with oral ibuprofen , acetaminophen , or placebo . MAIN OUTCOME MEASURE Recurrence of febrile seizures . RESULTS The children experienced 851 febrile episodes , and 89 of these included a febrile seizure . Febrile seizure recurrences occurred in 54 of the 231 children ( 23.4 % ) . There were no significant differences between the groups in the main measure of effect , and the effect estimates were similar , as the rate was 23.4 % ( 46 of 197 ) in those receiving antipyretic agents and 23.5 % ( 8 of 34 ) in those receiving placebo ( difference , 0.2 ; 95 % confidence interval , -12.8 to 17.6 ; P = .99 ) . Fever was significantly higher during the episodes with seizure than in those without seizure ( 39.7 degrees C vs 38.9 degrees C ; difference , 0.7 degrees C ; 95 % confidence interval , -0.9 degrees C to -0.6 degrees C ; P < .001 ) , and this phenomenon was independent of the medication given . CONCLUSIONS Antipyretic agents are ineffective for the prevention of recurrences of febrile seizures and for the lowering of body temperature in patients with a febrile episode that leads to a recurrent febrile seizure OBJECTIVE To analyze clinical , electrophysiologic , and neuroradiologic characteristics and prognostic factors in a group of patients with temporal lobe epilepsy ( TLE ) and complex partial seizures ( CPS ) occurring exclusively or predominantly after they fall asleep or before they awaken . BACKGROUND CPS arising during sleep are classically identified with frontal lobe epilepsy . TLE associated with seizures occurring only or predominantly during sleep ( nocturnal TLE ) is less common . METHODS From a series of patients with refractory TLE studied between 1980 and 1996 , the authors identified 26 patients ( 15 men ) with nonlesional nocturnal TLE ( mean age , 40 years ) . Clinical and laboratory characteristics of these individuals were studied and compared with a group of 72 age-matched , r and omly selected patients with nonlesional TLE and predominantly diurnal seizures ( diurnal TLE ) . RESULTS Mean age at seizure onset was similar for both groups ( 16.3 versus 18.7 years ) . In the nocturnal TLE group , 2 of 26 patients had a positive family history of epilepsy , 18 reported an aura , 4 presented with CPS in clusters , 11 had unilateral and 15 bilateral temporal EEG abnormalities , and 14 of 21 studied had unilateral mesial temporal atrophy . None of these factors differed significantly in the two groups except for higher frequency of the following in the diurnal TLE group compared with the nocturnal TLE group : positive family history for epilepsy ( 33 % versus 8 % , p=0.01 ) , estimated frequency of seizures ( median , 14 versus 2 per month ; p < 0.01 ) , and presence of antecedent febrile convulsions ( 33 % versus 11 % , p=0.04 ) . In the nocturnal TLE group , eight patients underwent surgical therapy and became seizure free ( follow-up , > 12 months ) . Only two were seizure free on medication . CONCLUSIONS Infrequent and nonclustered seizures , rare family history of epilepsy , and low prevalence of childhood febrile convulsions characterize nocturnal TLE . Within the TLEs , the nocturnal TLE form seems to have a better surgical prognosis This study aim ed to determine the reliability of clinical history and seizure semiology for distinguishing between frontal lobe seizures ( FLS ) and temporal lobe seizures ( TLS ) . FLS patients ( n=23 ) were consecutively identified through an epilepsy surgery data base . TLS patients ( n=27 ) were selected r and omly from 238 patients who had undergone temporal lobe surgery for epilepsy . The criterion st and ard for seizure localization was the location of resective epilepsy surgery that controlled seizures for a minimum of 2 years . Blinded comparisons of 13 historical information items ( HII ) and 19 video-recorded semiologic features ( VSF ) were made . We identified 3 HII ( sex , history of febrile convulsions , and history of generalized tonic-clonic seizures ) and 2 VSF ( fencing posturing and postictal confusion ) that significantly distinguished between FLS and TLS . The multivariate analysis model correctly identified 87 % of FLS patients and 74 % of TLS patients . No single HII or VSF is sufficient for distinguishing between FLS and TLS . A model integrating multiple HII and VSF may assist in this differentiation , but some patients still may be misclassified The efficacy of short-term diazepam prophylaxis in  febrile convulsions  was evaluated in a prospect i ve , controlled study . A total of 289 consecutive children admitted with their first febrile seizure were r and omized into two groups . One group received short-term prophylaxis for 18 months with rectally administered diazepam in solution whenever the temperature was greater than or equal to 38.5 degrees C. The control group received no prophylaxis , but diazepam rectally in the event of new seizures . The short-term prophylaxis , a mean of five doses of diazepam per child per year , afforded effective seizure control ; the 18-month recurrence rate was reduced from 39 % to 12 % ( P less than 0.001 ) , the total number of recurrences from 77 to 23 ( P less than 0.001 ) , the long-lasting recurrences from 5.0 % to 0.7 % ( P less than 0.05 ) . The risk of subsequent epilepsy within the first 2 years was the same , regardless of receiving prophylaxis ( 3 % ) or not ( 3 % ) ; it was low after simple febrile convulsions ( no cases of epilepsy in 230 children ) but considerable after complex febrile seizures ( 20 % ) or seizures associated with severe interictal EEG abnormalities ( 50 % ) PURPOSE Febrile seizures are the commonest convulsive event in children younger than 5 years of age ( incidence of 2 - 5 % ) . Electroencephalography ( EEG ) is not indicated in the work up of simple febrile seizures . Information about its role in the assessment of complex febrile seizures ( CFSs ) is unclear and EEGs are frequently ordered . This study was design ed to assess utility of clinical variables at presentation in predicting the likelihood of an abnormal EEG . METHODS  EEG  requisitions , EEG reports , clinic charts and medical records over an 11-year period ( 1990 - -2001 ) were retrospectively review ed . The relationship between clinical variables like age , timing of the EEG since CFS , family history of seizures , neurological assessment and EEG abnormalities was statistically analyzed . RESULTS One hundred and seventy-five children were included in the study . Of these 39.43 % had EEG abnormalities . Children with a normal EEG were younger than those with an abnormal EEG ( mean age 15.72 months versus 19.75 months , p<0.05 ) . Using multivariate analysis , factors predictive of abnormal EEGs in children with CFS were ; age > 3 years ( p=0.010 ; 95 % CI : 1.5 - -18.8 ) , EEGs performed within 7 days ( p=0.00 ; 95 % CI : 1.78 - -7.12 ) and an abnormal neurological exam ( p=0.053 ; 95 % CI : 0.98 - -16.9 ) . A family history of febrile seizures was more likely to be associated with a normal EEG ( p=0.01 ; 95 % CI : 0.04 - -0.60 ) . CONCLUSIONS Clinical variables at presentation can be used to screen children with CFS for whom an EEG is considered . This may lead to better use of re sources . Whether abnormal EEG translates to future recurrences or epilepsy needs a prospect i ve study PURPOSE To distinguish various types of childhood severe cryptogenic/idiopathic generalised epilepsy on the basis of reproducible diagnostic criteria , using multiple correspondence analysis ( MCA ) . METHODS We applied MCA to a series of 72 children with no evidence of brain damage , starting epilepsy between 1 and 10 years , with two or more types of generalised seizures . We excluded patients with infantile spasms or typical absences .  MCA was performed on all clinical and EEG parameters , first throughout follow-up , then restricted to the first year of the disease . RESULTS When including all follow-up variables , there were three groups : ( 1 ) Thirty-seven children with male predominance , familial history of epilepsy , simple febrile convulsions , massive myoclonus , tonic-clonic fits . Outcome was favourable , with no seizures and mildly affected cognitive functions . Interictal EEG showed short sequences of irregular 3-Hz spike-waves . ( 2 ) In 18 children , clinical characteristics were similar to those of the first group at the early stage , but 95 % exhibited myoclonic status and vibratory tonic seizures , with persisting seizures on follow-up . EEG showed long sequences of generalised irregular spike and slow waves . Those two groups meet the characteristics of childhood onset myoclonic-astatic epilepsy ( MAE ) with respectively , favourable and unfavourable outcome . ( 3 ) Eleven children had later onset , atypical absences , tonic and partial seizures , and no myoclonus , or vibratory tonic seizures . All had mental retardation and persisting seizures . EEG showed long sequences of slow spike-wave activity and half the patients had spike and slow wave foci . These patients met the major characteristics of Lennox-Gastaut syndrome . Initial parameters failed to distinguish the first two groups , but Lennox-Gastaut syndrome ( the third group ) was distinct from both groups of myoclonic astatic epilepsy from the onset . Within MAE groups combined , clinical and EEG risk factors for mental retardation could be identified . CONCLUSION It is possible to vali date statistically the distinction between discrete epileptic syndromes . Myoclonic astatic epilepsy is therefore distinct from Lennox-Gastaut syndrome , and the distinction appears from the first year of the disorder Objective : To evaluate the efficacy and safety of adjunctive topiramate ( sprinkle capsules or oral liquid ) in reducing daily rates of partial-onset seizures ( POS ) in infants with refractory POS . Methods : In this double-blind , placebo-controlled , parallel-group , international study , infants ( n = 149 ) with clinical or EEG evidence of refractory POS were r and omly allocated ( 1:1:1:1 ) to receive adjunctive topiramate 5 , 15 , or 25 mg/kg/d or placebo for 20 days . The primary variable was the median percentage reductions in daily POS rate from baseline to final assessment as recorded on a 48-hour video-EEG . Results : Of the 149 infants ( mean age 12 months ) included in the intent-to-treat analysis set , 130 completed the study .  Median percentage reduction from baseline in daily POS rate was not significantly different ( p = 0.97 ) between topiramate 25 mg/kg ( 20.4 % ) and placebo ( 13.1 % ) . Lower doses were not formally tested , but nominal p values for comparisons with placebo were not significant ( 15-mg/kg/d dose : p = 0.97 ; 5-mg/kg/d dose : p = 0. 
    Output:
    
We found no RCTs as evidence to support or refute the use of EEG and its timing after complex febrile seizures among children .