ABSTRACT
Background: Febrile seizure is an event in infancy or childhood, usually occurring between 3 months and 5 years of age associated with fever but without evidence of intracranial infection. The aim of the study was to estimate the usefulness of neutrophil-to-lymphocyte ratio (NLR) in patients with simple and complex febrile seizures.Methods: Retrospective case control'' study was done in a paediatric in patients admitted to tertiary care hospital.' Study period'' was from January 2017 to December 2019. 200 children were analysed in the study. 100 out of 200 were under control group (febrile children without seizure). Remaining 100 were under case group (children with febrile seizure), 54 out of 100 children had'' complex febrile seizure, 46 out of 100 had simple febrile seizure. NLR ratio was done in all children.Results: Total 200 children were analysed in this study.'' High NLR ratio'' was noted among the cases (87 out of 100) compared to control (30 out of 100) p value = <0.001. Among the cases CFS had high NLR ratio compared to SFS, however p value was not significant (0.072).Conclusions: Children with febrile seizure had high NLR ratio compared to those without seizures. However no significant difference was noted between those with simple febrile seizure and complex febrile seizure'' However, larger trials are required'' to assess whether higher NLR can be taken as an independent risk factor for febrile seizure.
ABSTRACT
Background: Febrile seizures are the most common and benign convulsive disorder in childhood and a frequent cause of emergency hospital admission' Febrile Seizures (FS) are age-dependent and are rare before the age of 9 months and after 5 years of age, the peak age of onset is 14-18months. To assess the clinical profile in children with febrile seizures and compare these values with febrile children without seizures.Methods: The study included children admitted with bronchiolitis in between during the period of August 2018 to March 2019 at Department of Pediatrics, Raja Muthiah Medical College and Hospital. It is a case-control study. The study group includes 50 cases (febrile seizures) and 50 controls (fever without seizures) aged 6months to 5 years (6-60 months) attending the pediatric out-patient department.Results: 54% of the cases were male (27) and 46% of the cases were female (23). Male: female ratio was 1.17:1. Mean temperature in cases and controls were 101.61'1.31 'F and 101.17'0.86 'F respectively. The difference between the two groups was not statistically significant (p-value >0.05). duration of seizure was <5 minutes in 80% of cases (40/50) and >5mins in 20% of the cases (10/50).Conclusions: Simple febrile seizures may slightly increase the risk of developing epilepsy, but have no adverse effects on behaviour, scholastic performance, or neurocognition. The risk of developing epilepsy is increased further in children with a history of complex febrile seizures. A strong association exists between febrile status epilepticus or febrile seizures characterized by focal symptoms and later development of temporal lobe epilepsy.
ABSTRACT
Las crisis febriles ocurren entre el 2-5 % de niños, entre 3 meses y 6 años y puede guardar relación con síndromes epilépticos afines. Se realizó una revisión bibliográfica sobre el tema en la base de datos Medline y se complementó con información en las bases de datos de organizaciones, de las sociedades de neurología y de guías de práctica clínica, entre otras. El objetivo de este trabajo es presentar un cuerpo de recomendaciones según grado de evidencia, útiles para reforzar y dar respuesta a algunas interrogantes y situaciones clínicas que se les presentan a los pediatras, neuropediatras y neurólogos cuando se enfrentan a niños con crisis febriles. Las recomendaciones se presentan estructuradas en base a preguntas y respuestas. Se propone un algoritmo a seguir en el servicio de urgencia y orientaciones para la familia. Se establecen criterios para la definición de las crisis en simples, complejas y recurrentes, cuáles son los factores de riesgo de recurrencia y para desarrollar epilepsia. Se abordan otros aspectos como cuáles serían los principales diagnósticos diferenciales a considerar, cómo abordar el diagnóstico, qué utilidad tendrían los exámenes complementarios y cuándo se indican, cuál sería el manejo en urgencia, criterios de internación y cuándo prescribir tratamiento profiláctico intermitente o continuo. Los profesionales que enfrentan las crisis febriles deben estar capacitados para reconocerlas y ser óptimos en su atención inicial, seguimiento y tratamiento en los servicios de urgencia, hospitalarios o consultas externas pediátricas.
Febrile seizures occur in the 2 to 5% of children, from 3 months to 6 years, and can be related to similar epileptic syndromes. The objective of this paper is to present a body of recommendations according to the degree of evidence that are useful to reinforce and answer some questions and clinical situations that are presented to pediatricians, neuropediatricians and neurologists when faced to children with febrile seizures. A bibliographic review on the subject was carried out in Medline database and it was supplemented with information of the databases of organizations, neurology societies and clinical practice guidelines, among others. The recommendations are structured based on questions and answers. An algorithm to be followed in the emergency service and orientations for the family is proposed. Criteria are established for the definition of crises in simple, complex and recurrent, which are the risk factors of recurrence and to develop epilepsy, what would be the main differential diagnoses to consider, how to approach the diagnosis, what would be the usefulness of the complementary tests and when to be indicated; what would be the management in emergency; criteria of hospitalization and when to prescribe intermittent or continuous prophylactic treatment. The professionals who attended febrile seizures must be able to recognize them and be optimal in their initial care, follow-up and treatment in the emergency, hospital or pediatric outpatient services.
ABSTRACT
PURPOSE: Febrile seizure (FS) is the most common type of seizure. The role of genetic factors in FSs has long been recognized. A positive family history can be elicited in 25-40% of patients with FSs; nonetheless, the genes responsible for FSs in the majority of the population remain unknown. Interleukin-1beta (IL-1beta) is a pro-inflammatory cytokine that acts as an endogenous pyrogen. Thus, IL-1beta could be involved in the pathophysiology of FSs. METHODS: To determine whether or not single nucleotide polymorphisms of the IL-1beta gene are associated with susceptibility to simple FSs, IL-1beta promoter -31 and -511 genotyping was performed by means of polymerase chain reaction-restriction fragment (PCR-RF) length polymorphism in 40 FS patients (20 sporadic and 20 familial FS patients) and 33 controls. RESULTS: There were no significant differences in the frequencies of -31 C/T and -511 C/T in the IL-1beta promoter gene, between simple FS patients and controls. CONCLUSION: The frequency of CT/CT increased relatively in familial FS patients. A study examining a larger number of FS patients is needed.