Han Ji Yoon, Han Seung Beom
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Department of Pediatrics, Daejeon St. Mary's Hospital, Daejeon 34943, Korea.
Children (Basel). 2020 Nov 17;7(11):234. doi: 10.3390/children7110234.
Febrile seizure (FS) is a common benign seizure disorder of young children. Although upper respiratory tract infection is the cause of fever in most episodes of FS, studies to identify respiratory viruses using a multiplex polymerase chain reaction (mPCR) test have rarely been performed for children with FS. Medical records of children presenting with FS between January 2015 and December 2019 were retrospectively reviewed. Respiratory viruses identified by a rapid influenza detection test and mPCR test were investigated, and their seasonal distribution and the association between viral identification and seizure characteristics were determined. A total of 607 episodes of FS were analyzed: 81.1% of cases were generalized tonic-clonic seizures, 81.5% occurred within 24 h after fever onset, and 87.3% continued for ≤5 min. Complex FS occurred in 17.5% of FS episodes, and epilepsy was diagnosed in 2.5% of tracked cases. Of the 138 mPCR tests performed in 235 hospitalized episodes of FS, 112 (81.2%) tested positive for respiratory viruses: rhinovirus, enterovirus, adenovirus, and influenza virus were most frequently identified. The identified respiratory viruses showed similar seasonal distributions as were observed in community-acquired respiratory tract infections. The identification of a specific respiratory virus was not significantly associated with seizure characteristics or the development of complex FS. In conclusion, respiratory viruses, showing similar seasonal distributions with community-acquired respiratory tract infections and no significant association with the severity and outcomes of FS, should not be rigorously tested for in children with FS.
热性惊厥（FS）是幼儿常见的良性惊厥性疾病。尽管上呼吸道感染是大多数FS发作时发热的原因，但针对FS患儿使用多重聚合酶链反应（mPCR）检测来鉴定呼吸道病毒的研究却很少。对2015年1月至2019年12月期间出现FS的患儿的病历进行了回顾性分析。调查了通过快速流感检测试验和mPCR试验鉴定出的呼吸道病毒，确定了它们的季节分布以及病毒鉴定与惊厥特征之间的关联。共分析了607例FS发作：81.1%的病例为全身性强直阵挛性发作，81.5%在发热开始后24小时内发作，87.3%持续时间≤5分钟。17.5%的FS发作出现复杂性FS，2.5%的追踪病例被诊断为癫痫。在235例住院的FS发作中进行的138次mPCR检测中，112次（81.2%）呼吸道病毒检测呈阳性：最常鉴定出的是鼻病毒、肠道病毒、腺病毒和流感病毒。鉴定出的呼吸道病毒显示出与社区获得性呼吸道感染相似的季节分布。特定呼吸道病毒的鉴定与惊厥特征或复杂性FS的发生无显著关联。总之，呼吸道病毒与社区获得性呼吸道感染具有相似的季节分布，且与FS的严重程度和转归无显著关联，因此不应在FS患儿中进行严格检测。
