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Neuropediatrics 2020; 51(02): 154-159
DOI: 10.1055/s-0040-1701226
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Relationship between Sedative Antihistamines and the Duration of Febrile Seizures

Atsuro Daida 
1   Department of Pediatrics, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
2   Department of Pediatrics, Tokyo Medical University, Nishi-shinjuku, Shinjuku-ku, Tokyo, Japan
3   Division of Neurology, Saitama Children's Medical Center, Chuo-ku, Saitama-city, Saitama, Japan
,
Gaku Yamanaka
2   Department of Pediatrics, Tokyo Medical University, Nishi-shinjuku, Shinjuku-ku, Tokyo, Japan
,
Shin-ichi Tsujimoto
1   Department of Pediatrics, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
,
Mina Yokoyama
1   Department of Pediatrics, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
,
Kuniyoshi Hayashi
4   Graduate School of Public Health, St. Luke's International University, Chuo-ku, Tokyo, Japan
,
Kevin Y. Urayama
4   Graduate School of Public Health, St. Luke's International University, Chuo-ku, Tokyo, Japan
5   Department of Social Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
,
Yasushi Ishida
1   Department of Pediatrics, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
,
Atsushi Manabe
6   Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
,
Isao Kusakawa
1   Department of Pediatrics, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
,
Masaaki Ogihara
1   Department of Pediatrics, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
,
Hisashi Kawashima
2   Department of Pediatrics, Tokyo Medical University, Nishi-shinjuku, Shinjuku-ku, Tokyo, Japan
› Author Affiliations Funding There is no funding to disclose.
Further Information

Publication History

13 September 2019

22 November 2019

Publication Date:
14 January 2020 (online)

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Abstract

Some studies have shown that sedative antihistamines prolong febrile seizure duration. Although the collective evidence is still mixed, the Japanese Society of Child Neurology released guidelines in 2015 that contraindicated the use of sedative antihistamines in patients with febrile seizure. Focused on addressing limitations of previous studies, we conducted a cross-sectional study to evaluate the relationship between febrile seizure duration and the use of sedative antihistamines. Data were collected from patients who visited St. Luke's International Hospital due to febrile seizure between August 2013 and February 2016. Patients were divided into groups based on their prescribed medications: sedative antihistamine, nonsedative antihistamine, and no antihistamine. Seizure duration was the primary outcome and was examined using multivariate analyses. Of the 426 patients included, sedative antihistamines were administered to 24 patients. The median seizure duration was approximately 3 minutes in all three groups. There was no statistical difference in the bivariate (p = 0.422) or multivariate analyses (p = 0.544). Our results do not support the relationship between sedative antihistamine use and prolonged duration of febrile seizure. These results suggest that the use of antihistamines may be considered for patients with past history of febrile seizure, when appropriate.

Keywords

antihistamine - seizure duration - status epilepticus

Location of the Study

Data collection was performed at the Department of Pediatrics, St. Luke's International Hospital.


Author Contributions

A.D. was the principal investigator and designed the study, identified the subjects, and drafted the manuscript. S.T., M.Y., M.O., and I.K. conceived the study, and assisted in the design and implementation of the study. K.H., K.Y.U., Y.I. contributed to the analysis and interpretation of the data. G.Y., A.M., and H.K. provided critical revision of the manuscript for intellectual content. All authors reviewed the final draft of the manuscript and edited for content accuracy.


Ethical Approval

The study protocol was approved by the Institutional Review Board of St. Luke's International Hospital and was conducted according to the Declaration of Helsinki (approval number: 17-R106).


Supplementary Material

 

  • References

  • 1 Johnston MV. Seizures in childhood. In: Kliegman RM, Behrman RE, Jhenson HB, Stanton BMD. , eds. Nelson Textbook of Pediatrics. Elsevier; 2008: 2457-2458
    Google Scholar
  • 2 Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia 1994; 35 (Suppl. 02) S1-S6
    PubMedGoogle Scholar
  • 3 Nørgaard M, Ehrenstein V, Mahon BE, Nielsen GL, Rothman KJ, Sørensen HT. Febrile seizures and cognitive function in young adult life: a prevalence study in Danish conscripts. J Pediatr 2009; 155 (03) 404-409
    CrossrefPubMedGoogle Scholar
  • 4 Lewis DV, Shinnar S, Hesdorffer DC. , et al; FEBSTAT Study Team. Hippocampal sclerosis after febrile status epilepticus: the FEBSTAT study. Ann Neurol 2014; 75 (02) 178-185
    CrossrefPubMedGoogle Scholar
  • 5 Shinnar S, Bello JA, Chan S. , et al; FEBSTAT Study Team. MRI abnormalities following febrile status epilepticus in children: the FEBSTAT study. Neurology 2012; 79 (09) 871-877
    CrossrefPubMedGoogle Scholar
  • 6 Watanabe T, Yanai K. Studies on functional roles of the histaminergic neuron system by using pharmacological agents, knockout mice and positron emission tomography. Tohoku J Exp Med 2001; 195 (04) 197-217
    CrossrefPubMedGoogle Scholar
  • 7 Ishikawa T, Takechi K, Rahman A. , et al. Influences of histamine H1 receptor antagonists on maximal electroshock seizure in infant rats. Biol Pharm Bull 2007; 30 (03) 477-480
    CrossrefPubMedGoogle Scholar
  • 8 Yokoyama H, Onodera K, Maeyama K. , et al. Histamine levels and clonic convulsions of electrically-induced seizure in mice: the effects of α-fluoromethyl histidine and metoprine. Naunyn Schmiedebergs Arch Pharmacol 1992; 346 (01) 40-45
    CrossrefPubMedGoogle Scholar
  • 9 Iinuma K, Yokoyama H, Otsuki T. , et al. Histamine H1 receptors in complex partial seizures. Lancet 1993; 341 (8839): 238
    PubMedGoogle Scholar
  • 10 Yamashita Y, Isagai T, Seki Y, Ohya T, Nagamitsu S, Matsuishi T. West syndrome associated with administration of a histamine H1 antagonist, oxatomide. Kurume Med J 2004; 51 (3-4): 273-275
    CrossrefPubMedGoogle Scholar
  • 11 Kimura T, Watanabe A, Matsuoka T. Sedating antihistamines extend the duration of febrile convulsion [in Japanese]. No To Hattatsu 2014; 46 (01) 45-46
    PubMedGoogle Scholar
  • 12 Takano T, Sakaue Y, Sokoda T. , et al. Seizure susceptibility due to antihistamines in febrile seizures. Pediatr Neurol 2010; 42 (04) 277-279
    CrossrefPubMedGoogle Scholar
  • 13 Zolaly MA. Histamine H1 antagonists and clinical characteristics of febrile seizures. Int J Gen Med 2012; 5: 277-281
    PubMedGoogle Scholar
  • 14 Miyata I, Saegusa H, Sakurai M. Seizure-modifying potential of histamine H1 antagonists: a clinical observation. Pediatr Int 2011; 53 (05) 706-708
    CrossrefPubMedGoogle Scholar
  • 15 Natsume J, Hamano SI, Iyoda K. , et al. New guidelines for management of febrile seizures in Japan. Brain Dev 2017; 39 (01) 2-9
    CrossrefPubMedGoogle Scholar
  • 16 Subcommittee on Febrile Seizures; American Academy of Pediatrics. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics 2011; 127 (02) 389-394
    CrossrefPubMedGoogle Scholar
  • 17 Yanai K, Tashiro M. The physiological and pathophysiological roles of neuronal histamine: an insight from human positron emission tomography studies. Pharmacol Ther 2007; 113 (01) 1-15
    CrossrefPubMedGoogle Scholar
  • 18 Trinka E, Cock H, Hesdorffer D. , et al. A definition and classification of status epilepticus—Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia 2015; 56 (10) 1515-1523
    CrossrefPubMedGoogle Scholar
  • 19 R Development Core Team. R: A Language and Environment for Statistical Computing. Vienna: T Foundation for Statistical Computing; 2005. . ISBN 3–900051–07–0. Available at: http://www.R-project.org . Accessed January 11, 2016
    Google Scholar
  • 20 Hesdorffer DC, Benn EK, Bagiella E. , et al; FEBSTAT Study Team. Distribution of febrile seizure duration and associations with development. Ann Neurol 2011; 70 (01) 93-100
    CrossrefPubMedGoogle Scholar
  • 21 Hjeresen DL, Diaz J. Ontogeny of susceptibility to experimental febrile seizures in rats. Dev Psychobiol 1988; 21 (03) 261-275
    CrossrefPubMedGoogle Scholar
  • 22 Yonemoto K, Okanari K, Koga H. Optimal doses of H1 antihistamines do not increase susceptibility to febrile convulsions in children. Pediatr Neurol 2018; 87: 42-47
    CrossrefPubMedGoogle Scholar
  • 23 Takasu M, Kubota T, Tsuji T, Kurahashi H, Numoto S, Okumura A. The effects of antihistamines on the semiology of febrile seizures. Brain Dev 2019; 41 (01) 72-76
    CrossrefPubMedGoogle Scholar
  • 24 Tsujii T, Masuda S, Yamamoto E. , et al. Effects of sedative and nonsedative antihistamines on prefrontal activity during verbal fluency task in young children: a near-infrared spectroscopy (NIRS) study. Psychopharmacology (Berl) 2009; 207 (01) 127-132
    CrossrefPubMedGoogle Scholar
  • 25 Maytal J, Shinnar S. Febrile status epilepticus. Pediatrics 1990; 86 (04) 611-616
    PubMedGoogle Scholar