***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: 1 Sixty children with febrile convulsions under the age of 3 were maintained on prophylactic phenobarbital in a dose of 3–4 mg/kg given in divided dosage twice daily . Double the ordinary dose was given for the first 2 days to achieve a therapeutic serum concentration within a few days . The serum concentration was checked before discharge from the hospital and at intervals of 1–3 months for 6 months . 2 Among 27 children with a serum concentration habitually at or over 16 mg/1 , 1 had a brief febrile convulsion within 6 months ( serum concentration not determined at the time of the convulsion ) . When the serum concentration was habitually or at the time of the convulsion at or under 15 mg/1 , the incidence of recurrences was the same as in an untreated group , 21 % within 6 months . 3 It did not prove difficult to persuade the mothers to give the medication faithfully . There were few complications : hypersensitive rash in 1 , emotional instability in 1 and acute intoxication in 2 . If a few simple pre caution s are observed , prophylactic medication with phenobarbital is harmless and is effective in preventing recurrences The aim of this study was to evaluate the efficacy and tolerance of intermittent oral administration of diazepam during hyperthermia for reducing the recurrence of febrile seizure :  185 children , between 8 months and 3 years of age , with a first febrile seizure and normal neurologic development , were r and omly assigned in a double-blind fashion to receive orally administered diazepam ( 0.5 mg/kg , then 0.20 mg/kg , every 12 hours ) or placebo , whenever the rectal temperature was more than 38 degrees C. The main criterion of efficacy was the seizure recurrence rate 1 year after the first seizure . The duration of the study was 3 years ; eight different centers in France participated . There were 462 febrile episodes and 1000 days with prophylactic treatment . The recurrence rates did not differ between the diazepam group ( 16 % ) and the placebo ( 19.5 % ) group . The children with recurrent seizures were significantly younger at the time of the first seizure ( 17 + /- 6.9 months ) than children without a recurrent seizure ( 21 + /- 8.5 months ) . In children with recurrent seizures , prophylactic treatment was correctly administered to only 1 of 15 children in the diazepam group and to 7 of 18 children in the placebo group . The following were the reasons for this poor cooperation : convulsion being the first manifestation of the fever ( seven cases in each group ) , parents neglecting to give treatment ( nine cases ) , and refusal to take treatment by two children . Side effects were similar in the two groups except for hyperactivity , which was more frequent in the diazepam ( 138 days ) than in the placebo ( 34 days ) group . Intermittent oral administration of diazepam at the onset of fever offered no advantage over placebo in preventing recurrence of seizure . This finding probably reflects a lack of efficacy of the intermittent method rather than of diazepam itself We previously reported that IQ , was significantly lowered in a group of toddler-aged children r and omly assigned to receive phenobarbital or placebo  for febrile seizures and there was no difference in the febrile seizure recurrence rate . We retested these children 3 - 5 years later , after they had entered school , to determine whether those effects persisted over the longer term and whether later school performance might be affected . On follow-up testing of 139 ( of the original n=217 ) Western Washington children who had experienced febrile seizures , we found that the phenobarbital group scored significantly lower than the placebo group on the Wide Range Achievement Test ( WRAT-R ) reading achievement st and ard score ( 87.6 vs 95.6 ; p=0.007 ) . There was a nonsignificant mean difference of 3.71 IQ , points on the Stanford-Binet , with the phenobarbital-treated group scoring lower ( 102.2 vs 105.7 ; p=0.09 ) . There were five children in our sample with afebrile seizures during the 5-year period after the end of the medication trial . Two had been assigned to phenobarbital , and three had been in the placebo group . We conclude there may be a long-term adverse cognitive effect of phenobarbital on the developmental skills ( language /verbal ) being acquired during the period of treatment and no beneficial effect on the rate of febrile seizure recurrences or later nonfebrile seizures . Clin Pediatr . 1999;38:387 - 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 % ) A r and omized double-blind study was carried out comparing single daily dose phenobarbital plus antipyretic instruction to a placebo plus antipyretic instruction to prevent a recurrent seizure following an initial simple febrile seizure . Parents of 138 consecutive children presenting to an emergency room with a first simple febrile convulsion received verbal and written instructions about fever control . Seventy-nine then agreed to participate in this study . Children were r and omized to receive either placebo with riboflavin tracer ( n = 40 ) or phenobarbital 5 mg/kg in a single daily dose with a riboflavin tracer ( n = 39 ) for 12 months or until another seizure occurred . Urine fluorescence for riboflavin was used to monitor compliance in all patients . Serum phenobarbital levels were obtained at each follow-up visit and averaged 1.4 mg/dl throughout the study . The significant difference ( P less than 0.02 ) in the incidence of recurrent seizures between patients receiving phenobarbital ( 2/39 ) and those receiving placebo ( 10/40 ) suggests that a single daily dose of phenobarbital is more effective than counseling parents about antipyretic therapy in preventing recurrent seizures following an initial febrile seizure Acetaminophen and low doses of diazepam were evaluated for the prevention of recurrences of febrile seizures in a placebo-controlled , double-blind trial . Children after their first febrile seizure were assigned to receive either one dose of rectally administered diazepam , and then , after 6 hours , oral doses of 0.2 mg/kg three times a day for the first 2 days if the fever stayed greater than 38.5 degrees C , or a placebo similarly during forthcoming febrile episodes . In addition , each febrile episode was r and omly assigned to be treated with acetaminophen or the placebo . Thus four groups were examined for 2 years : patients receiving two kinds of placebo , patients receiving diazepam and a placebo , patients receiving acetaminophen and a placebo , and patients receiving both diazepam and acetaminophen . Of a total of 180 patients ( 102 boys ) , 161 were followed for the 2-year period and 157 were seen at the last outpatient examination : 80 in the diazepam group and 77 in the placebo group . The final analysis of the efficacy of the drugs was made on the basis of the data from 153 patients who had had at least one febrile episode during follow-up . There were 641 fever events during this period , and 38 children ( 21.1 % ) had 55 recurrences of febrile seizures .  Acetaminophen had no effect on the recurrence rate . Seizures recurred at least once in 21 patients ( 28.4 % ) receiving diazepam and 17 ( 21.5 % ) receiving a placebo ( p = 0.4138 , log-rank test ) . The combination of antipyretic agents with anticonvulsant medication did not reduce the recurrence of febrile seizures . Our results show that low doses of acetaminophen or diazepam or both are ineffective for preventing febrile seizures After their first episode of febrile convulsions , 195 previously healthy children , aged 6 - -30 months , were given either diazepam or phenobarbitone for a year . Each child was assigned at r and om to one of the two medications : children admitted on even days were given a suppository containing 5 mg diazepam every 8 hours when the rectal temperature was greater than or equal to 38.5 degree C. Children admitted on odd days were given treatment with phenobarbitone , 3.5 + /- 1 mg/kg per day . 156 children completed treatment and outpatient control for a year , 83 in the diazepam and 73 in the phenobarbitone group . The rate of recurrence was independent of the prophylactic and 15 - -16 % of the children in both groups had new febrile convulsions within a year . The recurrence rate after 6 months was also similar , 11 % in the diazepam group and 9 % in the phenobarbitone group . New convulsions were of similar duration and severity in both groups . In both groups 6 % of all febrile episodes led to new convulsions . Long-term treatment with phenobarbitone thus offered no advantage over intermittent diazepam The purpose of this study was to compare three different modes of treatment in the prevention of relapses of febrile convulsions  ( Phenobarbital = PH , Sodium Valproate = SV , Placebo = PO ) in a r and omized therapeutic trial . The patients included in the study had shown their first generalized convulsive seizure during a bout of fever ( greater than or equal to 38.5 degrees C ) and were aged between 6 months and 4 years . They were subsequently followed up as out patients , and Phenobarbital and sodium valproate levels were measured regularly to ascertain compliance with the treatment and to adjust the dosage accordingly . The patients ' families were question ed with respect to the occurrence of feverish bouts and convulsive seizures during the interval between visits , as well as possible adverse reactions . An  EEG  was carried out yearly . Results were as follows : - 69 patients - 35 boys and 34 girls - with an average age of 24 months were divided into 3 groups according to treatment : 21 cases on PH , 22 cases on SV , and 26 cases on PO . - they were followed up for an average duration of 21 months . - the average number of feverish bouts per child and per year was evaluated at 2.5 , no statistically significant difference being noticeable between the various modes of prophylaxis . - 15 relapses of febrile seizures were noted in 14 children , over an average duration of 23 months ; on average , relapses occurred after 9 months ; among the 14 children who had relapsed , one had been treated with SV , 4 with PH and 9 with PO , leading to estimated relapse rates of 4 % , 19 % , and 35 % respectively . There is a statistically significant difference in the relapse rates between the treated groups ( SV and PH ) and the Placebo group , and a particularly significant difference between Sodium Valproate and Placebo . ( ABSTRACT TRUNCATED AT 250 WORDS A r and omized double blind placebo controlled trial was carried out to study the effect of phenobarbitone ( PB ) in preventing recurrences of simple and atypical febrile convulsions among children in the age group 6 months to 6 years . Children with simple febrile convulsions were r and omly allocated to receive either phenobarbitone or placebo .  Children with atypical convulsions were treated with phenobarbitone , as a third group . Thirty children were admitted in each group . All the children were followed up for a period of twelve months . Recurrence of convulsions and side effects of PB were recorded . Recurrence occurred in only 7 % ( 95 % confidence interval : 1 - 22 ) of children on Phenobarbitone , suffering from either simple or atypical febrile convulsions , compared to 53 % ( 95 % confidence interval : 34 - 72 ) of children on placebo , suffering from simple febrile convulsions . With Phenobarbitone , 5 % of children had intolerable side effects . These results suggest that long term prophylaxis with phenobarbitone , even in simple febrile convulsions will be useful Phenobarbital is widely used in the treatment of children with febrile seizures , although there is concern about possible behavioral and cognitive side effects . In 217 children between 8 and 36 months of age who had had at least one febrile seizure and were at heightened risk of further seizures , we compared the intelligence quotients 
    Output:
    
Prophylaxis with either phenobarbital or diazepam reduces recurrences of febrile seizures .