RESUMEN
Introduction: Febrile seizure is a common paediatric problem. Identifying children with febrile seizure who are at risk for recurrence is important so that special attention can be given to them. The objective of this study was to identify the risk factors for recurrence of febrile seizures in children. Materials and Methods: This was a prospective cohort study done at Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal. This study is a continuation of a previous study which looked at the leucocytosis in peripheral blood of children with febrile seizure. A detailed history including the risk factors for febrile seizure recurrence was obtained from the caregiver during follow up on subsequent days after discharge of children from the hospital who were previously admitted for febrile seizure. All children with febrile seizure belonging to age group of 6 months to 6 years were included in the study. Those with afebrile seizures or on anticonvulsants and those who refused to give consent were excluded. Each child was also examined and investigated for the cause of fever. Results: A total of 115 children with febrile seizure admitted for febrile seizure during the study period and all of them were followed up at outpatient department. Males accounted 62% and females 38%. Simple Febrile Seizures were seen in 80% of the cases and complex febrile seizures were seen in 20%. Out of all the cases 68(59%) had symptoms of viral prodrome. 59(51%) had recurrent febrile seizure. Low temperature at onset of Febrile Seizure (p=0.001), short duration of fever before onset of Febrile Seizure (0.026) and atypical Febrile Seizure (p=0.022) were the risk factors for recurrent febrile seizure. Conclusion: Febrile Seizure is a common paediatric problem commonly seen in males. Almost half of children with Febrile Seizure are at risk for recurrence in later date. The risk factors for these recurrences are modest rise in body temperature at the onset of febrile seizure, onset of seizure within 12 hours of fever and atypical presentation.
RESUMEN
Introduction: Febrile seizure (FS) is a common condition affecting 2-5% of children. Peripheral blood leucocyte count with its differential is an initial test looking for the cause of fever and high count is usually accounted for the seizure activity. Objectives: To find the incidence of febrile seizure and to evaluate the relationship between fever duration before seizure, seizure duration and the total leucocyte as well as neutrophil response. Methodology: It is a cross sectional study done at Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal, for one year. After an informed consent, children from 6 months to 6 years with FS were admitted. Those with afebrile seizures and who refused to give consent were excluded. A detail history and examination was done on admission. All were investigated for the source of fever including total and differential count. Results: Out of a total 1742 children admitted, 115 (6.6%) children had febrile seizure. Simple febrile seizure was observed in 93(81%) and 22(19%) was complex febrile seizure. 42% of them had leucocytosis. The duration of fever before the onset of seizure is found to be negatively correlated with total leucocyte count (r = -0.418, p<0.001) and neutrophils count alone (r = -0.375, p<0.001). The duration of seizure is not correlated to both the total leucocyte count (r = -0.162, p = 0.85) and the neutrophil (r = -0.109, p= 0.247). Conclusion: The incidence of febrile seizure is 6.6%. Leucocytosis and neutrophilia in children is negatively correlated with the duration fever before the onset of seizure, associated with underlying infection if any and is not related to seizure event and its duration. Thus any child with febrile seizure with high leucocyte count should be evaluated for infection.