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首次复杂性热性惊厥儿童是否需要进行急诊神经影像学检查?

Is There Any Need for Emergency Neuroimaging in Children With first Complex Febrile Seizure?

作者信息

Hassanzadeh Rad Afagh, Tabrizi Manijeh, Dadashzadeh Peyman, Aminzadeh Vahid

机构信息

Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Iran J Child Neurol. 2020 Summer;14(3):69-78.

Abstract

OBJECTIVES

The current study aimed to assess the need for emergency neuroimaging in children with first CFC.

MATERIALS AND METHODS

This is an analytic cross-sectional study conducted on children aged 6-60 months with first CFC. Data were gathered by a form that evaluates age, sex, imaging type, body temperature, and the duration of fever before convulsion, the duration and frequency of convulsion, and family history of FC. Data were analyzed via the Fisher Exact Test in SPSS version 19.

RESULTS

A total of 111 patients participated in this study with first CFC and mean age of 21.18±11.83 months. Regarding the type of CFC, the results showed that the highest and lowest frequencies belonged to multiple and multiple focal prolonged FC, respectively. Upper respiratory infection was the most common diagnosis. Also, 2 nonsignificant abnormal neuroimaging results were noted.

CONCLUSION

Performing emergency neuroimaging in patients with first CFC was not mandatory in the absence of developmental disorders, abnormal neurologic examination, underlying neurological disorder, and head trauma. This is an important result in our country due to the lack of access to neuroimaging modalities in many hospitals, and the irradiation risk in childhood and its high cost.

摘要

目的

本研究旨在评估首次发生复杂性热性惊厥(CFC)的儿童进行急诊神经影像学检查的必要性。

材料与方法

这是一项针对6至60个月大首次发生CFC的儿童进行的分析性横断面研究。通过一份表格收集数据,该表格评估年龄、性别、影像学检查类型、体温、惊厥前发热持续时间、惊厥持续时间和频率以及热性惊厥家族史。数据在SPSS 19版本中通过Fisher精确检验进行分析。

结果

共有111例首次发生CFC的患者参与本研究,平均年龄为21.18±11.83个月。关于CFC的类型,结果显示最高和最低频率分别属于多次发作和多次局灶性长时间发作的CFC。上呼吸道感染是最常见的诊断。此外,还发现了2例无统计学意义的神经影像学异常结果。

结论

在没有发育障碍、神经系统检查异常、潜在神经系统疾病和头部外伤的情况下,首次发生CFC的患者并非必须进行急诊神经影像学检查。由于我国许多医院无法提供神经影像学检查手段,以及儿童期的辐射风险和高昂费用,这是一个重要的结果。

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