Birca Ala, Guy Nathalie, Fortier Isabel, Cossette Patrick, Lortie Anne, Carmant Lionel
Faculté de Médecine, Centre de Recherche de l'Hôpital Sainte-Justine, Université de Montréal, 3175 Côte Ste-Catherine, Montréal, Que., Canada H3T 1C5.
Eur J Paediatr Neurol. 2005;9(5):339-45. doi: 10.1016/j.ejpn.2005.03.001. Epub 2005 Jun 23.
To assess the influence of the family history (FH) of epilepsy or febrile seizures (FSs) on the clinical presentation of FSs and on their outcome.
We reviewed the charts of 482 children admitted to the Ste-Justine Hospital with FSs between 3 months and 6 years of age and followed for at least 5 years.
Children with a positive FH of epilepsy (n=67) showed significantly more focal and recurrent FSs than those without such a FH. The risk of developing partial epilepsy (n=17) or generalized epilepsy (n=19) was significantly greater in children with focal or recurrent FSs, respectively. In children with focal FSs, only two out of 30 (6.7%) children with a negative FH of epilepsy developed partial epilepsy compared with four out of nine (44.4%) children with a positive FH. In children with recurrent FSs, as much as seven out of 34 (20.6%) children with a positive FH of epilepsy developed generalized epilepsy compared to only eight out of 161 (0.05%) of those with a negative FH. Nevertheless, when not taking into account the clinical presentation of FSs, the positive FH of epilepsy constituted a risk factor for developing generalized but not partial epilepsy. Finally, children with a positive FH of FSs (n=120) exhibited significantly more recurrent FSs than those without such a FH, but this did not modify the risk of epilepsy.
The FH of FSs and/or epilepsy should be taken into account when evaluating the risk of FSs recurrence and of epilepsy.
评估癫痫或热性惊厥（FSs）家族史（FH）对FSs临床表现及其预后的影响。
我们回顾了482例年龄在3个月至6岁之间因FSs入住圣贾斯汀医院且随访至少5年的儿童病历。
癫痫家族史阳性的儿童（n = 67）与无此类家族史的儿童相比，局灶性和复发性FSs明显更多。局灶性或复发性FSs的儿童发生部分性癫痫（n = 17）或全身性癫痫（n = 19）的风险分别显著更高。在局灶性FSs儿童中，癫痫家族史阴性的30名儿童中只有2名（6.7%）发生了部分性癫痫，而家族史阳性的9名儿童中有4名（44.4%）发生了部分性癫痫。在复发性FSs儿童中，癫痫家族史阳性的34名儿童中有7名（20.6%）发生了全身性癫痫，而家族史阴性的161名儿童中只有8名（0.05%）发生了全身性癫痫。然而，不考虑FSs的临床表现时，癫痫家族史阳性是发生全身性癫痫而非部分性癫痫的危险因素。最后，热性惊厥家族史阳性的儿童（n = 120）与无此类家族史的儿童相比，复发性FSs明显更多，但这并未改变癫痫风险。
在评估FSs复发和癫痫风险时，应考虑热性惊厥和/或癫痫的家族史。
