1. Rectal acetaminophen reduces rates of second febrile seizure (FS) in children during the course of the same febrile illness when given rectally soon after initial seizure.
2. Acetaminophen use in the setting of FSs was not associated with increased serious adverse events or neurologic sequelae.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Febrile illnesses are the most common cause of seizures in the pediatric population. Many children experience multiple seizures during the course of one febrile illness, yet data on the prevention of recurrent convulsions is lacking. While acetaminophen is often used to decrease discomfort related to fevers, the relationship between antipyretics and the recurrence of FSs has not been studied. This randomized controlled trial evaluated the utility of acetaminophen to reduce recurrence of FSs within a single fever episode, and described the safety of acetaminophen use in this context. Findings indicated that children who received rectal acetaminophen after a febrile seizure were significantly less likely to experience a second seizure during the same illness course compared with children who did not receive acetaminophen. Furthermore, no study participants experienced serious adverse reactions (e.g. hypotension, anaphylaxis, etc.) associated with acetaminophen use. This study is limited by potential discrepancies in accuracy and sufficiency of body temperature monitoring, as the route of temperature measurement was unclear. Results from this study suggest acetaminophen could be effective in minimizing recurrence of a second convulsion in children presenting with FSs, without increasing rates of adverse events…