Clinical features of children with febrile seizures caused by Omicron variant infection / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features of children with febrile seizures after Omicron variant infection.@*METHODS@#A retrospective analysis was performed on the clinical data of children with febrile seizures after Omicron variant infection who were admitted to the Department of Neurology, Children's Hospital Affiliated to the Capital Institute of Pediatrics, from December 1 to 31, 2022 (during the epidemic of Omicron variant; Omicron group), and the children with febrile seizures (without Omicron variant infection) who were admitted from December 1 to 31, in 2021 were included as the non-Omicron group. Clinical features were compared between the two groups.@*RESULTS@#There were 381 children in the Omicron group (250 boys and 131 girls), with a mean age of (3.2±2.4) years. There were 112 children in the non-Omicron group (72 boys and 40 girls), with a mean age of (3.5±1.8) years. The number of children in the Omicron group was 3.4 times that in the non-Omicron group. The proportion of children in two age groups, aged 1 to <2 years and 6-10.83 years, in the Omicron group was higher than that in the non-Omicron group, while the proportion of children in two age groups, aged 4 to <5 years and 5 to <6 years, was lower in the Omicron group than that in the non-Omicron group (P<0.05).The Omicron group had a significantly higher proportion of children with cluster seizures and status convulsion than the non-Omicron group (P<0.05). Among the children with recurrence of febrile seizures, the proportion of children aged 6-10.83 years in the Omicron group was higher than that in the non-Omicron group, while the proportion of children aged 3 years, 4 years, and 5 years in the Omicron group was lower than that in the non-Omicron group (P<0.05).@*CONCLUSIONS@#Children with febrile seizures after Omicron variant infection tend to have a wider age range, with an increase in the proportion of children with cluster seizures and status convulsion during the course of fever.

Convulsão febril: estudo de base populacional / Febrile seizures: a population-based study

Resumo Objetivos Estabelecer a prevalência das crises febris e descrever o perfil clínico e epidemiológico dessa população. Métodos Estudo transversal de base populacional feito em Barra do Bugres (MT), de agosto de 2012 a agosto de 2013. Os dados foram coletados em duas etapas. Na primeira etapa usamos um questionário validado previamente em outro estudo brasileiro, para identificação de casos suspeitos de crises epilépticas. Na segunda etapa fizemos a avaliação neuroclínica para confirmação diagnóstica. Resultados A prevalência de crise febril foi de 6,4/1.000 habitantes (IC95% 3,8; 10,1). Não houve diferença entre os sexos. As crises febris simples foram encontradas em 88,8% dos casos. A história familiar de crise febril e epilepsia em parentes de primeiro grau esteve presente em 33,3% e 11,1% dos pacientes, respectivamente. Conclusões A prevalência da crise febril na Região Centro-Oeste foi menor do que a encontrada em outras regiões brasileiras, provavelmente relacionado à inclusão apenas das crises febris com manifestações motoras e as diferenças de fatores socioeconômicos entre as regiões pesquisadas.

Abstract Objectives To determine the prevalence of benign febrile seizures of childhood and describe the clinical and epidemiological profile of this population. Methods This was a population-based, cross-sectional study, carried out in the city of Barra do Bugres, MT, Brazil, from August 2012 to August 2013. Data were collected in two phases. In the first phase, a questionnaire that was previously validated in another Brazilian study was used to identify suspected cases of seizures. In the second phase, a neurological evaluation was performed to confirm diagnosis. Results The prevalence was 6.4/1000 inhabitants (95% CI: 3.8-10.1). There was no difference between genders. Simple febrile seizures were found in 88.8% of cases. A family history of febrile seizures in first-degree relatives and history of epilepsy was present in 33.3% and 11.1% of patients, respectively. Conclusions The prevalence of febrile seizures in Midwestern Brazil was lower than that found in other Brazilian regions, probably due to the inclusion only of febrile seizures with motor manifestations and differences in socioeconomic factors among the evaluated areas.

Niveles séricos bajos de zinc como factor asociado a episodio de convulsión febril simple en niños de 6 meses a 5 años atendidos en el Instituto de Salud del Niño, Lima Perú / Low serum levels of zinc as a factor associated with episode of simple febrile seizure in children of 6 months to 5 years attended at the Institute of child health, Lima Peru

Niveles séricos bajos de Zinc como factor asociado a episodio de convulsión febril simple en niños de 6 meses a 5 años atendidos en el Instituto de Salud del Niño, Lima-Perú. La convulsión febril es la forma más común de convulsiones en niños. Su patogénesis exacta no está completamente dilucidada, pero es multifactorial. El zinc modula la actividad de múltiples enzimas y de esta manera niveles bajos podrían activar ciertos receptores e inducir una descarga epiléptica en niños febriles. Sin embargo su relación con el desarrollo de convulsiones es aún poco estudiada. A pesar del su aparente buen pronóstico, las convulsiones febriles simples continúan siendo causa importante de ansiedad e incertidumbre. Objetivos: Determinar si existe asociación entre los niveles séricos bajos de zinc y la presencia de un episodio de convulsión febril simple entre los niños de 6 meses a 5 años que ingresan por emergencia del Instituto de Salud del Niño. Metodología: Estudio observacional, analítico, caso control. La unidad de análisis fueron pacientes entre 6 meses y 5 años que se atendieron en el INSN durante Julio 2013 a Junio 2014 con diagnóstico de convulsión febril simple. El muestreo fue no probabilístico de voluntarios, obteniendo un total de 57 casos y 103 controles. Se analizó antecedente de prematuridad, duración de lactancia materna, historia familiar de convulsión febril y de epilepsia, cuidado en guarderías y dosaje sérico bajo de zinc. Se usó el Chi cuadrado y se obtuvo OR respectivos. Los antecedentes útiles fueron evaluados usando regresión logística múltiple. Se consideró un nivel de confianza del 95 por ciento con un valor de p<0.05. Resultados: Se encontró diferencia estadísticamente significativa en la duración Lactancia Materna exclusiva y niveles séricos bajos de zinc. Utilizando la regresión logística múltiple se encontró que la Lactancia Materna Exclusiva otorga 0.34 veces menos riesgo de convulsionar con fiebre y que tener niveles séricos bajos de...

Low serum zinc levels as an associate factor to episode of simple febrile seizure in children 6 months to 5 years old treated at the Institute of Child Health, Lima Peru. Febrile seizure is the most common form of seizures in children. Its exact pathogenesis is not fully elucidated, but is multifactorial. Zinc modulates the activity of multiple enzymes and thus low levels may activate certain receptors and induce an epileptic discharge in febrile children. But their relationship with the development of seizures is still poorly studied. Despite his apparent good prognosis, simple febrile seizures remain a major cause of anxiety and uncertainty. Objectives: To determine the association between low serum zinc levels and the presence of an episode of simple febrile seizure among children 6 months to 5 years old admitted for emergency Institute of Child Health. Methods: An observational, analytical, case control study. The unit of analysis was patient between 6 months and 5 years who was treated at the INSN during July 2013 to June 2014 with a diagnosis of simple febrile seizure. The non-probability sampling was voluntary, obtaining a total of 57 cases and 103 controls. I analyzed antecedent prematurity, duration of breastfeeding, family history of febrile seizures and epilepsy, daycare and low serum zinc dosage. Chi square was used and obtained respective OR. Useful background were evaluated using multiple logistic regression. A confidence level of 95 per cent was considered with a P value <0.05. Results: Statistically significant difference was found in exclusive breastfeeding duration and low serum zinc. Using multiple logistic regression analysis found that exclusive breastfeeding gives 0.34 times less risk of convulsions with fever and have low serum zinc gave you 3 times more risk of convulsions with fever...

Convulsión febril / Febrile seizure

Febrile seizures are the most common seizure disorder in the pediatric population and represent a frequent cause of consultation in emergency departments, confirming its importance. We present an updated and practical review regarding this pathology, along with an operative definition that supports the application of a flowchart that integrates concepts and procedures that can be easily applied at any location nationwide. This review is designed to provide an analytic framework regarding pediatric febrile seizures, as well as present a guideline based on our experience in the emergency department by summarizing the main benzodiazepines in actual use that have been proved to be both safe and effective in treating this disorder, such as lorazepam and midazolam...

Meningite bacteriana aguda na infância: fatores de risco para complicações agudas e sequelas / Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae

OBJETIVO: Estudo retrospectivo que visa avaliar as complicações neurológicas agudas e sequelas neurológicas das meningites bacterianas agudas na infância, a fim de determinar possíveis sinais de alerta. MÉTODOS: Foram avaliadas crianças (entre 1 mês e 14 anos) internadas entre 2003 e 2006, com meningite bacteriana aguda. RESULTADOS: Dos 44 pacientes incluídos, 17 (38,6%) apresentaram complicações neurológicas agudas, sendo crise convulsiva a mais frequente (31,8%). Os pacientes com complicações neurológicas agudas apresentaram com mais frequência: menor contagem de neutrófilos (p = 0,03), crise convulsiva na admissão (p < 0,01) e S. pneumoniae como agente etiológico (p = 0,01). Os fatores de risco para o desenvolvimento de complicações neurológicas agudas foram: S. pneumoniae [razão de chances (odds ratio, OR) = 6,4; intervalo de confiança (IC) 1,7-24,7] e contagem de neutrófilos < 60% (p < 0,01). De 35 pacientes seguidos ambulatorialmente, 14 apresentaram sequelas neurológicas (40%), sendo alteração comportamental a mais frequente. A ocorrência de crise convulsiva na internação (OR = 5,6; IC 1.2-25,9), proteinorraquia > 200 mg/dL (p < 0,01) e menor relação glicorraquia/glicemia (p < 0,01) foram identificadas como variáveis de risco para sequelas. CONCLUSÃO: Contagem de neutrófilos < 60%, crise convulsiva na admissão e S. pneumoniae como agente etiológico foram identificados como sinais de alerta para a ocorrência de complicação neurológica aguda, enquanto que proteinorraquia, menor relação glicorraquia/glicemia e crise convulsiva na internação foram observados como fatores de risco para a ocorrência de sequelas neurológicas.

OBJECTIVE: To assess acute neurological complications and neurological sequelae of childhood acute bacterial meningitis in order to determine possible warning signs. METHODS: This retrospective study evaluated children with acute bacterial meningitis (between 1 month and 14 years of age) admitted between 2003 and 2006. RESULTS: Of the 44 patients studied, 17 (38.6%) had acute neurological complications. Seizure was the most frequent (31.8%) complication. Patients with acute neurological complications showed a higher frequency of lower neutrophil count (p = 0.03), seizure at admission (p < 0.01), and S. pneumoniae as the etiologic agent (p = 0.01). Risk factors for the development of acute neurological complications were S. pneumoniae (odds ratio [OR] = 6.4, confidence interval [CI] 1.7-24.7) and neutrophil count < 60% (p < 0.01). Of the 35 patients who were followed up, 14 had neurological sequelae (40%). Behavioral change (22.9%) was the most frequent sequela. Seizures at admission (OR = 5.6, CI 1.2-25.9), cerebrospinal fluid protein concentration > 200 mg/dL (p < 0.01), and cerebrospinal fluid glucose concentration/glycemia ratio (p < 0.01) were identified as risk variables for sequelae. CONCLUSION: Neutrophil count < 60%, seizure at admission, and S. pneumoniae as the etiologic agent were identified as warning signs for acute neurological complications, while protein levels, cerebrospinal fluid glucose concentration/glycemia ratio, and seizure at admission were seen as risk factors for neurological sequelae.

Convulsión febril en niños de 0 a 14 años de edad: Hospitales de San José e Infantil Universitario de San José, Bogotá D. C / Febrile convulsions in children aged 0 to 14 yearsconsulting to Hospital de San José and Hospital infantil Universitario de San José, Bogotá DC

Las convulsiones febriles en niños son un problema común a nivel mundial, debido a las múltiples patologías que pueden cursar con fiebre y desencadenar una convulsión. Un cuadro gripal con temperatura superior a 38°C puede ser suficiente para provocarlas. Consideramos indispensable conocer más acerca de esta patología y por ello nos propusimos profundizar e informar. Objetivo: describir las características clínicas y sociodemográficas de los pacientes con convulsión febril. Metodología: estudio descriptivo. Se incluyeron pacientes que consultaron a los Hospitales de San José e Infantil Universitario de San José en el período agosto 2007 a agosto 2009, que hubiesen presentado una primera convulsión febril. Se excluyeron aquellos con diagnóstico de epilepsia, en tratamiento con anticonvulsivantes, que no presentaran fiebre o no se describiera la convulsión en la historia clínica. Resultados: de un total de 468 casos (213 HSJ + 255 HIUSJ) 147 eran de 0 a 14 años de edad, encontrando que el 80,3% (118/147) presentó convulsiones tonicoclónicas. De ellos 53,4% fueron niñas, 48,3% cursaron con convulsiones simples, 80,5% no tuvieron período posictal, 43,2% no presentaron ninguna comorbilidad y cuando las hubo fueron las infecciones del sistema respiratorio las más frecuentes (23,7%). Conclusiones: se identificaron las características clínicas y sociodemográficas de los pacientes con convulsión febril, mediante la revisión de las historias clínicas, tabulación de los datos obtenidos y comparación de resultados.

A febrile convulsion is a common medical problem affecting children worldwide for it is associated to a great number of febrile conditions in which a convulsion may be precipitated. A common cold with temperature that rises over 38°C may be enough to provoke a seizure. We consider it essential to gain further knowledge on this topic, thus, we intended to explore and report. Objective: to describe the clinical and socio-demographic features of patients presenting a febrile convulsion. Methodology: descriptive study. Children who consulted to Hospital San José (HSJ) and Hospital Infantil Universitario de San José (HIUSJ) between August 2007 and August 2009, including those who had presented their first febrile convulsion. Excluding those with diagnosed epilepsy receiving anticonvulsant therapy, those who presented afebrile convulsions and those in which seizure was not described in clinical record. Results: of 468 cases (213 HSJ + 255 HIUSJ) 147 were aged 0 to 14 years, 80.3% (118/147) presented tonic-clonic seizures. 53.4% were girls, 48.3% were simple convulsions, 80.5% had no postictal period, 43.2% had no comorbidities and when present were usually related to respiratory infections (23.7%). Conclusions: clinical and socio-demographic features were identified by a clinical record, data tabulation and result comparison review.

Febrile Convulsion

Febrile convulsion [FC] is the most common type of seizure in childhood. This benign seizure does not usually result in serious neuro-developmental complications, but it may recur in one third. 25-40% of patients with FC have a positive family history but the possibility of a seizure disorder is low in their future. Early evaluation must be performed to find the etiology of fever after stopping the seizure attack and prevent any unnecessary para-clinical work up. The possibility of a bacterial infection like bacteremia or its serious complications such as meningitis must be the important aim of FC evaluation study. The essential education and providing the necessary information for parents with enough treatment could decrease their anxiety. The disease is worked up and treated with the help of different specialists in medicine, from general physician to pediatric sub-specialists. Therefore, sufficient knowledge is needed by different groups of physicians

Mesial temporal sclerosis in children

Mesial temporal sclerosis is the most frequent cause of drug-resistant temporal lobe epilepsy but has a satisfactory response to surgery, and is considered infrequent in children. OBJECTIVE: To evaluate the clinical, electrographic and radiological spectrum of the disease in children. METHOD: Retrospective study by review of charts of 44 children with a diagnosis of mesial temporal sclerosis on magnetic resonance imaging, attended at the "Hospital das Clínicas" of the University of São Paulo Faculty of Medicine. RESULTS: Febrile seizure was identified in the history of 54 percent of the patients. Injuries at the left side predominated in patients with schooling difficulties (p=0.049), in those with the first seizures between six months and five years (p=0.021) and in those with complex febrile seizure (p=0.032). Thirteen patients were submitted to surgery and of these, eight remained without seizures. CONCLUSION: Febrile seizure may be related in a more direct way to the presence of left-side mesial temporal sclerosis.

Em adultos, esclerose mesial temporal é a causa mais freqüente de epilepsia do lobo temporal intratável por medicamentos e que responde satisfatoriamente a cirurgia, sendo considerada pouco freqüente em criança. OBJETIVO: Avaliar o espectro clínico, eletrográfico e radiológico desta patologia em crianças. MÉTODO: Estudo retrospectivo, por revisão de prontuário de 44 crianças com diagnóstico de esclerose mesial temporal na ressonância magnética, atendidos no Hospital das Clínicas da Faculdade de Medicina de São Paulo. RESULTADO: Foi identificado que 54 por cento dos pacientes apresentaram antecedente de crise febril. Lesão no lado esquerdo predominou nos pacientes com dificuldade escolar (p=0.049), naqueles com primeiras crises entre seis meses e cinco anos (p=0,021) e naqueles com crise febril complicada (p=0,032). Treze pacientes foram operados, dos quais oito ficaram livres de crises. CONCLUSÃO: Crise febril pode estar relacionada de uma forma mais direta à presença de esclerose mesial temporal no lado esquerdo.

Causes of fever in children with first febrile seizures: how common are human herpesvirus-6 and dengue virus infections?

This study was conducted to evaluate the etiologies of pyrexia in children with first febrile seizures using a prospectively recorded medical protocol, bacterial culture, and serologic tests for human herpesvirus-6 (HHV-6), dengue virus and Japanese B encephalitis (JE) virus. Of 82 children with first febrile seizures, who were between 3 months and 3 years old and had been admitted to Bhumibol Adulyadej Hospital between January 1997 and December 1998, 41 were boys and 41 were girls, with a mean age of 14.7 months. The average maximal body temperature was 39.7 degrees C. Approximately 70% of the children developed seizures on the first day of fever and the duration of the seizures varied from 1 to 30 minutes. In addition to fever and seizure, common symptoms and signs included coryza, diarrhea, vomiting, inflamed tympanic membranes and rash. The causes of fever documented upon discharge were, in order of frequency, upper respiratory tract infection, nonspecific febrile illness, diarrhea, urinary tract infection, viral infection, pneumonia, herpangina, measles, pneumococcal bacteremia and dengue fever. Serologic tests for HHV-6 IgM were positive in seven children (8.5%), and serologic tests for dengue and JE viruses were negative in all cases.

Convulsiones febriles en pediatría / febrile seisures in pediatrics

La convulsión febril es el trastorno neurológico más común y de ingreso a las salas de emergencia en las casas de salud de los 6 meses a los 6 años; por ello nuestro objetivo es actualizar el conocimiento en la etiología, la fisiopatología, la clasificación y protocolizar la atención en este tipo de pacientes. El sexo masculino es el más susceptible, ninguna prueba de laboratorio puede confirmar o descartar que el episodio que se produjo es una convulsión o que la causa que lo desencadenó haya sido la fiebre. El electroencéfalograma tiene poco valor en la evaluación por ello se considera innecesario realizarlo luego de la primera convulsión. En sospecha de convulsión febril no es necesario realizar la tomografía y la resonancia magnética...

Febrile convulsions in children

The term febrile convulsion is not a diagnostic entity. It simply describes any seizure that occurs in response to a febrile stimulus. It usually occurs between the age of 3 months and 5 years and occurs in 2-4% of young children. The typical febrile convulsion is a generalized tonic clonic seizure lasting between a few seconds and 15 minutes, followed by a period of drowsiness. Febrile seizures tend to occur in families, although the exact mode of inheritance is not known. Viruses are the most common cause of illness in children admitted to the hospital with a first febrile seizure. Routine laboratory studies are not indicated for patients who have febrile seizures and should be performed only as part of the evaluation for a source of fever. Prognosis is generally good. Only a small minority of children develop epilepsy or recurrent non-febrile seizures. Children with febrile seizures are at no greater risk of intellectual impairments than their peers. Treatment to prevent recurrence has not been shown to prevent later development of epilepsy

Risk Factors for a febrile sebrile seizure: a matched case-control study

To determine risk factors of a febrile seizure among United Arab Emirates children. Match case-control study. Al-Ain Medical Health District, Tawam and Al Ain Teaching Hospital of Faculty of Medicine and Health Sciences. Seventy patients with febrile seizure were identified and were matched to 70 control febrile patients without seizure with the same age range 6 to 36 months, who attended the same hospital during the same period of time. Mothers of cases and controls were interviewed by telephone. If the mother was not available, the father was interviewed. Factors were investigated. Analysis was based on matched case-control and logistic regression analysis. The mean and standard deviation for age were 18.0 +/- 11.0 months for cases and 15.1 +/- 6.7 months for controls. Factors for the United Arab Emirates children found to be male gender, having respiratory infection, positive family history of febrile seizure, prematurely, and having abnormal developmental milestones. Sixty five presents were found to have febrile seizure for the first time. Febrile seizure was found to have a peak incidence of first febrile seizure at time of the first birthday. It had seasonal variation, peaking in winter and summer. The characteristics of the febrile seizure in United Arab Emirates children were found to be having seizure with 10 minutes duration and above, but not longer than 30 minutes; simple seizure, having only one attack at time of admission and having a high temperature with respiratory infection. In the United Arab Emirates the risk factors for febrile seizure has been shown to be genetic factors, age, gender, and seasonality. It is recommended to establish health educational programs for mothers about febrile convulsion and how to deal with the children during the attack

Dermatoglifos palmares en niños con convulsiones febriles / Palmodigital dermatoglyphic phenotypes in children with febrile convulsions

Se estudiaron los dermmatoglifos palmares de 30 niños con convulsiones febriles y sus controles, pareadas para edad, sexo y origen étnico. El grupo problema incluyó 19 niños y 11 niñas con convulsiones febriles no complicadas, con edad promedio 3.3 ñ 1.1 años. Ningún paciente tuvo historia de más de cuatro episodios; en 15 de ellos la crisis ocurrió por primera vez. Nueve niños (30 por ciento) tuvieron una historia familiar positiva para trastornos convulsivos. En ambos grupos, casos controles, se compararon los promedios y las frecuencias de 84 variables dermatoglíficas palmodigitales considerando por separado el sexo y la lateralidad. Sólo la presencia de la línea Sydney bilateral, mostró una frecuencia estadísticamente mayor en los niños con convulsiones febriles de 11/30 (36.6 por ciento) vs 3/30 (10 por ciento) en el grupo control (p<0.05). El resto de las variables no mostro diferencias entre ambos grupos. Se comenta el hecho de que un estudio previo mostró una mayor frecuencia de la línea simiana en los niños con convulsiones febriles; este hallazgo parece guardar relación con las evidencias del presente estudio, las que pueden ser resultado de la expresividad variable o pleiotropismo de una misma influencia genética. El encontrar este pliegue único de flexión palmar en niños con convulsiones febriles aporta información acerca de la heredabilidad o susceptibilidad genética para este problema.