Dexamethasone has high anti-inflammatory action (almost 20-30 times that of hydrocortisone) and longer half life (36-54 hours) as compared to hydrocortisone (8-12 hours). Dexamethasone effect starts within 6 hours and peaks at 24 hours. Hydrocortisone effect starts within 1-2 hours.
Loading dose of phenobarbitone is required if the patient had acute and uncontrolled convulsions. In a child with convulsive history but no convulsions at presentation, loading dose in not required.
Most of the febrile convulsions are brief and last for a few minutes. Prolonged convulsion may make the child prone to epilepsy and medial temporal sclerosis.