ABSTRACT
Justification: Febrile seizures are quite common in children but there are controversies in many aspects of their diagnosis and management. Methods: An expert group consisting of pediatric neurologists and pediatricians was constituted. The modified Delphi method was used to develop consensus on the issues of definitions and investigations. The writing group members reviewed the literature and identified the contentious issues under these subheadings. The questions were framed, pruned, and discussed among the writing group members. The final questions were circulated to all experts during the first round of Delphi consensus. The results of the first round were considered to have arrived at a consensus if more than 75% experts agreed. Contentious issues that reached a 50- 75% agreement was discussed further in online meetings and subsequently voting was done over an online platform to arrive at a consensus. Three rounds of Delphi were conducted to arrive at final statements. Results: The expert group arrived at a consensus on 52 statements. These statements pertain to definitions of febrile seizures, role of blood investigations, urine investigations, neuroimaging, electroencephalography (EEG), cerebrospinal fluid analysis and screening for micronutrient deficiency. In addition, role of rescue medications, intermittent anti-seizure medication and continuous prophylaxis, antipyretic medication and micronutrient supplementation have been covered. Conclusion: This consensus statement addresses various contentious issues pertaining to the diagnosis and management of febrile seizures. Adoption of these statements in office practice will improve and standardize the care of children with this disorder.
ABSTRACT
Background: Febrile seizure is the most common type of seizure disorder that occurs in children aged 6-60 months. Recurrences are common. This study was conducted to evaluate the epidemiology, clinical profile and laboratory parameters of children presenting with febrile seizure in a teaching hospital.Methods: This was a descriptive retrospective study among children presenting with febrile seizure admitted to KIMS, Bengaluru from March (2018-2019). Children between six months to five years were included in the study while patients with prior episodes of afebrile seizures, abnormal neurodevelopment and not meeting the age criteria were excluded. Patient’s demographic and clinical data were collected from the in-patient records and analysed.Results: Among 60 children with febrile seizures were enrolled in our study with highest prevalence in males (58%) and amongst 13-24 months age group (37%). Majority (20%) presented in the monsoon season (June) and in the morning hours (43%). Simple febrile seizures and complex febrile seizures were observed in 60% and 40% respectively. Majority (73%) who developed first episode of seizure were below 24 months ago with mean age of 18.71±11.50 months. 42% had recurrence and was significantly associated with first episode of febrile seizures at age ≤1 year and family history of seizures. Upper respiratory tract infections were the commonest cause of fever. Anaemia and leucocytosis were seen in 72% and 70% cases respectively.Conclusions: Febrile seizure was observed predominantly in children below two years, simple febrile seizure being the commonest. Recurrence was common and significantly associated with the first episode of febrile seizure at the age one year or below and family history. Majority had anaemia which showed that iron deficiency anaemia could be a risk factor. Leucocytosis was present in most which could be either due to underlying infection or due to the stress of seizure itself.
ABSTRACT
Background: Febrile seizure is a common problem in children below 5years of age. This study was conducted to evaluate the clinical profile of children presenting with febrile seizures and to identify the risk factors for recurrence of febrile seizures in these children in a teaching hospital.Methods: A matched case-control study was conducted over a year period from November 2017 to November 2018 in the Department of Pediatrics. One hundred patients with febrile seizures admitted, aged 6-60 months were matched with another one hundred children having fever but without seizure with the same age range, attending the same hospital during the same period. Patients with prior episodes of afebrile seizures, abnormal neurodevelopment, on anticonvulsants and not meeting the age criteria were excluded.Results: The mean age and standard deviation for cases were 25.8'15.19 months and for control was 29.9'18.5 months. Out of which 64% had a febrile seizure for the first time and 36% had recurrent febrile seizures and 64% were males. Simple febrile seizure and complex febrile seizure were observed in 76.7% and 23.3% of patients respectively. The majority of children (71.8%) had a generalized tonic-clonic seizure followed by tonic seizures. Upper respiratory tract infections were the commonest cause of fever in these children. Low temperature at the onset of Febrile Seizure (p=0.001), short duration of fever before the onset of Febrile Seizure (0.026) and atypical Febrile Seizure (p=0.022) were the risk factors for a recurrent febrile seizure.Conclusions: Febrile Seizure is a common pediatric problem seen in males, observed predominantly in children below the age of two years and simple febrile seizure was the commonest variety. Almost one-third of children with Febrile Seizure are at risk for recurrence at a later date. The risk factors for these recurrences are modest rise in body temperature at the onset of febrile seizure, the onset of seizure within 12 hours of fever and atypical presentation.
ABSTRACT
Background & Objectives: Febrile seizures are the most common convulsive disorder in children under 5 years old. Among these children, some develop recurrent febrile seizures. The objective of this study was to describe clinical characteristics of children with febrile seizures and to identify risk factors for developing recurrent seizures. Methods: A retrospective study was conducted from January 2004 to December 2013 in Chiang Mai University Hospital. Infants and children between 6 months and 5 years of age who were diagnosed with febrile seizures were included in this study. Clinical characteristics of children and all factors associated with seizure recurrence were extensively reviewed using electronic medical records. Results: There were 335 cases included for analysis. The mean age at onset of febrile seizures was 1.85 ± 0.95 years; 64.78 % were males. Among 261 cases who presented with first episode of febrile seizures, 52 cases (19.92%) developed recurrent febrile seizures. Respiratory tract infections were the most frequent etiology of febrile illnesses. Younger age at onset and family history of febrile seizures were statistically significant predictors of developing recurrent febrile seizures (p = <0.001 and 0.02, respectively). After adjusting the confounding variables, similar findings were found from the multiple logistic regression analysis (p = 0.003 and 0.01 respectively). Conclusion: In this study, younger age at onset of first febrile seizure and family history of febrile seizures were found to increase the risk of the recurrence of febrile seizures.
Subject(s)
Seizures, FebrileABSTRACT
PURPOSE: We performed this study to investigate the clinical features of febrile seizure (FS) and to identify prognostic factors of recurrence of FS on Jeju Island, South Korea. METHODS: A hospital-based retrospective study was performed in 307 children with FS whose first episode developed between July 2005 and June 2013 seen at the Pediatric Department of Jeju National University Hospital. RESULTS: 307 children (189 boys and 118 girls) were enrolled in this study. Based on first FS semiology, 97.1% (298/307) of cases manifested as generalized seizure and 2.9% of cases showed focal seizure. Moreover, 23.5% (72/307) of cases had complex FS as the first FS. The average age at the first FS was 18.4 months. A family history of FS or epilepsy was found in 30.6% and 5.2% of patients, respectively. Recurrence occurred in 67.6% of patients; among them, 93.7% had their first recurrence within 1 year. Multivariate analysis identified the following factors as significant predictors of recurrence of FS: early onset of FS (< or =15 months of age) and a family history of FS. CONCLUSIONS: We identified the following risk factors for recurrence of FS: early onset of FS (< or =15 months of age) and a family history of FS.
Subject(s)
Child , Humans , Epilepsy , Korea , Multivariate Analysis , Recurrence , Retrospective Studies , Risk Factors , Seizures , Seizures, FebrileABSTRACT
Las crisis epilépticas son un problema neurológico que afecta entre un 4-10 por ciento de los niños hasta los 16 años. Las crisis deben ser diferenciadas de otros desórdenes neurológicos de los niños y clasificadas según su tipo. El tratamiento de emergencia está focalizado en la estabilización del paciente, terminar con la actividad convulsiva y determinar la causa de ésta. Diferentes modalidades de tratamiento existen a largo plazo, pero el adecuado tratamiento va a depender de un diagnóstico correcto y el conocimiento de los beneficios y efectos adversos de la terapia indicada.
Seizures are a neurological problem that affects between 4 to 10 per cent of children up to age 16. The crisis must be differentiated from other neurological disorders of children and classified by type. Emergency treatment is focused on stabilizing the patient, ending the seizure activity and determine the cause of this. There are different treatment modalities in the long term, but proper treatment will depend on a correct diagnosis and awareness of the benefits and adverse effects of prescribed therapy.