Kimura Masahiko, Taketani Takeshi, Kurozawa Youichi
Kimura Children and Family Clinic, Izumo, Japan.
Department of Pediatrics, Shimane University, Faculty of Medicine, Izumo, Japan.
Brain Dev. 2019 Nov;41(10):848-853. doi: 10.1016/j.braindev.2019.07.009. Epub 2019 Aug 12.
To determine the incidence of prolonged febrile seizures and status epilepticus in the first three years of life.
A questionnaire was sent to 1560 families between April 2016 and March 2017 before their child attended a routine health check at three years of age in Izumo, Shimane prefecture, Japan. The questionnaire included an overview of febrile seizures, including the age at which febrile seizures occurred, the duration, and how the condition was managed.
We received 1089 (69.8%) responses and these showed that 134 (12.3%) children had a history of febrile seizures. Fourteen children with febrile seizures (10.4%) had prolonged seizures lasting 10-30 min and six children (4.5%) had status epilepticus. Ongoing febrile seizures that did not terminate on arrival to the hospital were observed in 11 children (8.2%) with febrile seizures. The incidence rates of status epilepticus, prolonged febrile seizures including status epilepticus and ongoing febrile seizures were 184, 612 and 337 per 100,000 children aged 36 months or less, respectively.
There was a greater incidence of status epilepticus than previously thought, possibly due to the high prevalence of febrile seizures in Japan. Eight percent of children with febrile seizures were seizing on arrival to the hospital. These ongoing seizures requiring emergency interventions were almost twice more than status epilepticus. Thus, it is necessary to develop an early intervention for the termination of prolonged febrile seizures.
确定3岁前儿童长时间热性惊厥和癫痫持续状态的发病率。
在2016年4月至2017年3月期间,向日本岛根县出云市1560个家庭发放问卷,这些家庭的孩子即将在3岁时进行常规健康检查。问卷内容包括热性惊厥概述,如热性惊厥发生的年龄、持续时间以及病情处理方式。
共收到1089份回复(69.8%),结果显示134名儿童(12.3%)有热性惊厥病史。14名热性惊厥儿童(10.4%)出现持续10 - 30分钟的长时间惊厥,6名儿童(4.5%)出现癫痫持续状态。11名热性惊厥儿童(8.2%)在入院时热性惊厥仍未终止。癫痫持续状态、包括癫痫持续状态在内的长时间热性惊厥以及入院时仍在发作的热性惊厥的发病率分别为每10万名36个月及以下儿童中184例、612例和337例。
癫痫持续状态的发病率高于此前预期,这可能是由于日本热性惊厥的高患病率所致。8%的热性惊厥儿童在入院时仍在惊厥。这些需要紧急干预的持续惊厥几乎是癫痫持续状态的两倍。因此,有必要制定针对终止长时间热性惊厥的早期干预措施。