Gupta Ajay
Continuum (Minneap Minn). 2016 Feb;22(1 Epilepsy):51-9. doi: 10.1212/CON.0000000000000274.
This article provides an update on the current understanding and management of febrile seizures. Febrile seizures are one of the most common age-related epileptic convulsions that lead to outpatient consultations, emergency department visits, and hospital or intensive care admissions.
The Consequences of Prolonged Febrile Seizures in Childhood (FEBSTAT) study, an ongoing multicenter prospective longitudinal study, is providing valuable insights into the subset of patients who develop febrile status epilepticus, the most life-threatening type of febrile seizures with potential long-term consequences. Mutations in voltage-gated ion channels and neurotransmitter receptor genes have been shown to result in familial occurrence of febrile seizures and epilepsy. Acute abortive treatment of febrile seizures using a commercially available rectal delivery kit has gained widespread use by nonmedical caregivers as a first-line treatment at home.
Most febrile seizures are self-limiting episodes with low risk of injury, death, and long-term neurologic consequences. Most fevers and infections that cause febrile seizures are relatively benign and do not require extensive testing or procedures. Long-term management requires thorough assessment and risk stratification to devise a customized plan for each child, paying attention to the caregiver situation at home and day care. Most important treatment efforts are directed at caregiver education and, when appropriate, on effective use of abortive seizure treatment at home.
本文提供了关于热性惊厥当前认识和管理的最新信息。热性惊厥是最常见的与年龄相关的癫痫性惊厥之一，常导致门诊咨询、急诊就诊以及住院或重症监护收治。
儿童期长时间热性惊厥的后果（FEBSTAT）研究是一项正在进行的多中心前瞻性纵向研究，它为那些发展为热性惊厥持续状态的患者亚组提供了宝贵见解，热性惊厥持续状态是最危及生命的热性惊厥类型，可能产生长期后果。电压门控离子通道和神经递质受体基因的突变已被证明会导致热性惊厥和癫痫的家族性发生。使用市售直肠给药套装对热性惊厥进行急性终止治疗已被非医疗护理人员广泛用作家庭一线治疗方法。
大多数热性惊厥是自限性发作，受伤、死亡和长期神经后果风险较低。大多数引起热性惊厥的发热和感染相对良性，不需要广泛的检查或程序。长期管理需要全面评估和风险分层，以便为每个孩子制定定制计划，同时关注家庭和日托机构的护理人员情况。最重要的治疗工作是针对护理人员进行教育，并在适当的时候指导在家中有效使用终止惊厥发作的治疗方法。
