'Simple Febrile Convulsion'-Reply

In Reply .—I enjoyed Dr Schnitzker's letter. The controversy over management of the infant or child who has had his first febrile seizure is not ended but will continue, and each physician will have to determine management of his patient on the basis of his own experience and his reading. I believe that we have learned that the infant with a first febrile seizure who has had an abnormal perinatal history or who is suspected of having CNS disease or abnormality is at high risk and warrants prophylactic phenobarbital. Much less certain is the course of the normal infant and the risk he runs from febrile seizures. I favor awaiting a second seizure in the normal infant because the number who will go on to a second seizure is less and because we are not entirely sure that continuous phenobarbital treatment to maintain an adequate prophylactic level is without harm