热性惊厥患者的临床特征及预防性评估

Clinical Features and Evaluation in Terms of Prophylaxis of Patients With Febrile Seizures.

作者信息

Kılıç Betül

机构信息

Department of Pediatric Neurology, Health Sciences University Faculty of Medicine, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

出版信息

Sisli Etfal Hastan Tip Bul. 2019 Aug 27;53(3):276-283. doi: 10.14744/SEMB.2019.30633. eCollection 2019.

DOI:10.14744/SEMB.2019.30633

PMID:32377096

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7192276/

Abstract

OBJECTIVES

Febrile seizures are the most common seizure type of childhood, and prognosis is usually good. Many factors that increase the risk of recurrence and develop epilepsy have been identified. This study aims to determine the clinical characteristics of patients who were admitted with the febrile seizure, and determine the outcomes of the treatment, and the risk factors.

METHODS

Between January 2017 and January 2019, 147 (42.6%) female and 198 (57.4%) male patients who were admitted with febrile seizure, and aged between 3-60 months were included in the study.

RESULTS

The mean age at the time of admission was 30.4±15.4 months, and the mean age of the first seizure was 21.2±12.8 months. Simple febrile seizure was seen in 247 (71.6%) patients, and complex febrile seizure was seen in 89 (25.8%) patients while febrile status epilepticus was present in 9 (2.6%) patients. Amongst the patients, 59.1% of them had a history of repetitive febrile seizure. First-degree relatives of thirty (8.69%) patients had a history of epilepsy, while 176 (51%) patients had a family history of febrile seizure. Two hundred and seventy-five patients (79.7%) found to have an infection, most frequently upper respiratory tract infection (53.8%), during the examination, which might cause fever. One hundred and ninety-five patients were followed without treatment, while 48.6% of the patients were treated with rectal diazepam, 23.3% with sodium valproate, 23.3% with levetiracetam and 4.6% with phenobarbital. At the end of the one-year follow-up, only four patients (1.15%) with complex febrile seizure were diagnosed with epilepsy. The age of the onset of febrile seizures, family history of febrile seizures, short episodes of febrile seizure and the presence of epilepsy in the family history were found to be the significant risk factors for repetitive seizures.

CONCLUSION

Febrile seizures are generally benign and have a low risk of developing epilepsy. Determining the risk factors is essential for the treatment and follow-up plan.

摘要

目的

热性惊厥是儿童期最常见的惊厥类型，预后通常良好。已确定许多增加复发风险和发展为癫痫的因素。本研究旨在确定因热性惊厥入院患者的临床特征，确定治疗结果及危险因素。

方法

2017年1月至2019年1月，纳入147例（42.6%）女性和198例（57.4%）男性因热性惊厥入院且年龄在3至60个月之间的患者。

结果

入院时平均年龄为30.4±15.4个月，首次惊厥的平均年龄为21.2±12.8个月。247例（71.6%）患者为单纯性热性惊厥，89例（25.8%）患者为复杂性热性惊厥，9例（2.6%）患者为热性惊厥持续状态。在这些患者中，59.1%有反复热性惊厥病史。30例（8.69%）患者的一级亲属有癫痫病史，176例（51%）患者有热性惊厥家族史。检查发现275例（79.7%）患者有感染，最常见的是上呼吸道感染（53.8%），这可能导致发热。195例患者未接受治疗进行随访，而48.6%的患者接受直肠地西泮治疗，23.3%接受丙戊酸钠治疗，23.3%接受左乙拉西坦治疗，4.6%接受苯巴比妥治疗。在一年随访结束时，仅4例（1.15%）复杂性热性惊厥患者被诊断为癫痫。热性惊厥的发病年龄、热性惊厥家族史、热性惊厥发作时间短以及家族史中有癫痫被发现是反复惊厥的重要危险因素。