The use of diazepam rectal solution in febrile seizures and epilepsies in children

Diazepam rectal solution (rectal tubes) has been in use in Europe for about 20 years. Previous investigations as well as clinical use have shown that rectal diazepam is quickly absorbed and quickly obtains anticonvulsant plasma concentrations and is suitable for the treatment of common repeated epileptic seizures in children with febrile convulsions and uncontrolled epilepsies on long-term antiepileptic treatment. The dose is 0.5 - 1 mg/kg of body weight. With regard to the major technical difficulties of intravenous diazepam during seizures in children, especially in small children, rectal tubes represent a very suitable alternative method for physicians and the only useful method for non-professional personnel, including parents, which is very important in their everyday life with their children at risk. Opinions are divided about the aim of the use of diazepam rectal solution in the prophylaxis of simple febrile convulsions, although a significant reduction in the frequency of repeated seizures proves their efficacy. In view of the proven possibility of successful prophylaxis and the fact that fear and each new seizure is a very frustrating experience in the family, we absolutely advocate and implement prophylactic use. We think that the only problem is the parents’ compliance and therefore our task is to provide parents and other caretakers with detailed instructions about importance and technique of prophylaxis.