Hayakawa Itaru, Miyama Sahoko, Inoue Nobuaki, Sakakibara Hiroshi, Hataya Hiroshi, Terakawa Toshiro
Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan Department of Neurology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
J Child Neurol. 2016 Sep;31(10):1257-64. doi: 10.1177/0883073816652234. Epub 2016 Jun 8.
Pediatric convulsive status epilepticus with fever is common in the emergency setting but leads to severe neurological sequelae in some patients. To explore the epidemiology of convulsive status epilepticus with fever, a retrospective cohort covering all convulsive status epilepticus cases with fever seen in the emergency department of a tertiary care children's hospital were consecutively collected. Of the 381 consecutive cases gathered, 81.6% were due to prolonged febrile seizure, 6.6% to encephalopathy/encephalitis, 0.8% to meningitis, and 7.6% to epilepsy. In addition, seizures were significantly longer in encephalopathy/encephalitis cases than in prolonged febrile seizure cases (log rank test, P < .001). These results provide for the first time the pretest probability of final diagnoses in children with convulsive status epilepticus with fever in the emergency setting, and will help optimize the management of pediatric patients presenting to the emergency department with convulsive status epilepticus with fever.
小儿惊厥性癫痫持续状态伴发热在急诊环境中很常见，但在一些患者中会导致严重的神经后遗症。为了探究惊厥性癫痫持续状态伴发热的流行病学情况，我们连续收集了一家三级儿童专科医院急诊科所有惊厥性癫痫持续状态伴发热病例的回顾性队列。在收集的381例连续病例中，81.6% 是由于热性惊厥持续状态，6.6% 是由于脑病/脑炎，0.8% 是由于脑膜炎，7.6% 是由于癫痫。此外，脑病/脑炎病例的惊厥持续时间明显长于热性惊厥持续状态病例（对数秩检验，P <.001）。这些结果首次提供了急诊环境下小儿惊厥性癫痫持续状态伴发热患者最终诊断的验前概率，并将有助于优化对因惊厥性癫痫持续状态伴发热而就诊于急诊科的儿科患者的管理。
