Sir.—We read the article by Antony and Hawke1 about the place of phenobarbital sodium or carbamazepine in the prophylaxis of febrile seizures with interest.
In their double-blind trial they show that phenobarbital is the best anticonvulsant to prevent febrile seizures, and that carbamazepine is not effective. We do not share this viewpoint, based on our own experience.
In a prospective study during an 18-month trial,2 we showed that carbamazepine is very effective in atypical febrile seizures which begin before 1 year of age, have a focal onset, persist more than 15 minutes, are followed by a transient hemiplegia, or are accompanied by focal spikes on EEG recordings.
In another article,3 we showed that carbamazepine was very effective in the prophylaxis of febrile seizures in phenobarbital failures. In each instance, carbamazepine was well tolerated.
We think that carbamazepine can be useful in the prophylaxis of unusual febrile