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对于有热性惊厥的儿童,应考虑其神经发育问题。

Neurodevelopmental problems should be considered in children with febrile seizures.

机构信息

Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg and Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.

Institute of Psychology, Stockholm University, Stockholm, Sweden.

出版信息

Acta Paediatr. 2019 Aug;108(8):1507-1514. doi: 10.1111/apa.14716. Epub 2019 Feb 6.

Abstract

AIM

Clinical developmental phenotyping of four- to five-year-old children with febrile seizures (FSs).

METHODS

Children with FS (n = 157, corresponding to 3.7% of the targeted general population of four-five-year-olds) had been identified at child healthcare centres in Gothenburg. Parents of 73 children (41 boys, 32 girls) accepted participation in the present study. The assessments included a neuropaediatric assessment, Movement ABC, Wechsler Preschool and Primary Scale of Intelligence-III and parent questionnaires (Five-to-Fifteen (FTF) and Strengths and Difficulties Questionnaire (SDQ)). Hospital records were reviewed, when applicable.

RESULTS

One-third of the children had at least one DSM-5 neurodevelopmental disorder diagnosis or marked developmental problems within areas of attention, activity regulation, behaviour, speech and language, general cognition or motor functioning. No differences were found between children with single vs recurrent or simple vs complex FS.

CONCLUSION

Febrile seizure are relatively often associated with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCEs). We found no indications that ESSENCE might be caused by FS per se. However, the results suggest that child healthcare professionals should consider the possibility of ESSENCE in children with a history of FS.

摘要

目的

对 4-5 岁热性惊厥(FS)患儿进行临床发育表型分析。

方法

在哥德堡儿童保健中心发现 FS 患儿(n=157,占目标 4-5 岁普通人群的 3.7%)。73 名儿童的家长(41 名男孩,32 名女孩)同意参与本研究。评估包括神经儿科评估、运动 ABC、韦氏学前和小学智力量表-III 以及家长问卷(5-15 岁(FTF)和长处和困难问卷(SDQ))。在适用的情况下,还会查阅医院记录。

结果

三分之一的儿童有至少一种 DSM-5 神经发育障碍诊断或在注意力、活动调节、行为、言语和语言、一般认知或运动功能方面有明显的发育问题。单次 FS 与复发 FS、单纯 FS 与复杂 FS 之间无差异。

结论

热性惊厥通常与早期症状性综合征诱发神经发育临床检查(ESSENCEs)有关。我们没有发现 ESSENCE 可能由 FS 本身引起的迹象。然而,这些结果表明,儿童保健专业人员应该考虑在有 FS 病史的儿童中存在 ESSENCE 的可能性。

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