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热带地区一岁至五岁婴幼儿热性惊厥:住院频率、病因及转归

Febrile seizures in one-five aged infants in tropical practice: Frequency, etiology and outcome of hospitalization.

作者信息

Assogba Komi, Balaka Bahoura, Touglo Fidato A, Apetsè Kossivi M, Kombaté Damelan

机构信息

Neurology Service, Campus University Teaching Hospital, Lomé, Togo.

Department of Pediatric, Sylvanus Olympio University Hospital, Lomé, Togo.

出版信息

J Pediatr Neurosci. 2015 Jan-Mar;10(1):9-12. doi: 10.4103/1817-1745.154315.

Abstract

BACKGROUND

Convulsive seizures are the common neurological emergencies in developing regions.

OBJECTIVES

The aim was to determine the prevalence, causes and outcome of seizures in childhood.

PATIENTS AND METHODS

Participants were children aged 1-5 years old, admitted consecutively with a history of febrile convulsions or were presented seizures with fever during hospitalization, in two pediatric university hospitals. The prospective study covered a period from January to December 2013. At admission, emergency care and resuscitation procedures were provided according to the national guidelines. The history included the number and a parental description of seizures. Children with epilepsy, any central nervous system infections and other disease were excluded.

RESULTS

We have recorded 3647 children. Among them, 308 (8.4%) infants had presented with febrile seizures including 174 males and 134 females admitted to both pediatric hospitals (Tokoin University Teaching Hospitals: 206/3070, Campus University Teaching Hospitals: 102/577). Infants from 1 to 3 years age were the most common affected and constituted 65.9% of all patients. The months of September, December and January had recorded the high frequency of admission due to seizures. Regarding the seizures type, generalized tonic-clonic seizures were predominant (46.4%) followed by tonic seizures (17.2%) and status epilepticus in 9%. The etiologies were marked by falciparum malaria (52.3%), and other infections in 47.7%. At discharge, we have noted 11% (34/308) with neurodevelopmental disabilities, 6.7% of epilepsy and 9.7% (30/308) of death.

CONCLUSION

The febrile seizure in child younger 5 years is an indicator of severe malaria in tropical nations. The campaign for "roll back malaria" must continue in developing countries to avoid long-term gross neurological deficits.

摘要

背景

惊厥性癫痫发作是发展中地区常见的神经科急症。

目的

旨在确定儿童癫痫发作的患病率、病因及预后。

患者与方法

研究对象为年龄在1至5岁的儿童,他们在两家儿科大学医院连续入院,有高热惊厥病史或在住院期间因发热出现癫痫发作。这项前瞻性研究涵盖了2013年1月至12月期间。入院时,根据国家指南提供紧急护理和复苏程序。病史包括癫痫发作的次数及家长对发作情况的描述。排除患有癫痫、任何中枢神经系统感染及其他疾病的儿童。

结果

我们记录了3647名儿童。其中,308名(8.4%)婴儿出现高热惊厥,包括174名男性和134名女性,两家儿科医院均有收治(托科因大学教学医院:206/3070,校园大学教学医院:102/577)。1至3岁的婴儿受影响最为常见,占所有患者的65.9%。9月、12月和1月因癫痫发作入院的频率最高。关于癫痫发作类型,全身性强直阵挛发作占主导(46.4%),其次是强直发作(17.2%),癫痫持续状态占9%。病因以恶性疟原虫感染为主(52.3%),其他感染占47.7%。出院时,我们注意到11%(34/308)有神经发育障碍,6.7%患有癫痫,9.7%(30/308)死亡。

结论

5岁以下儿童的高热惊厥是热带国家严重疟疾的一个指标。发展中国家必须继续开展“遏制疟疾”运动,以避免长期严重的神经功能缺损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22eb/4395963/60bed6b0e088/JPN-10-9-g002.jpg

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