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Departments of Pediatrics and of Epidemiology and Community Medicine, Dalhousie University, and the IWK Children's Hospital, Halifax, Nova Scotia, Canada.
We randomized 31 children with a 1st afebrile unprovoked seizure to receive carbamazepine (CBZ) or no medication for 1 year or until the time of a 2nd seizure. All seizures had a focal onset or were generalized tonicclonic. Overall, 2/14 randomized to CBZ and 9/17 with no medication had a recurrent afebrile seizure. Compliance with CBZ was excellent in 12/14, but noncompliance may have contributed to 1 of the recurrences with CBZ. Four discontinued CBZ because of side effects. Two additional children taking CBZ had a febrile seizure. Thus, only 6/14 taking CBZ had a year completely seizure-free with no unacceptable medication side effects. Of those taking no medication, 2 had a febrile recurrence, and 7/17 had a year completely-seizure free. Side effects and febrile recurrences may limit the value of CBZ for some children, although CBZ appears to reduce significantly recurrences after a 1st afebrile seizure.
Address correspondence and reprint requests to Dr. P. Camfield, IWK Children's Hospital, Box 3070, Halifax, Nova Scotia B3J 3G9, Canada.
Supported in part by a grant from Ciba Geigy Canada Ltd.
Presented in part at the seventeenth annual meeting of the Child Neurology Society, Halifax, Nova Scotia, Canada, September 1988.
Received November 14, 1988. Accepted for publication in final form January 6, 1989.
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