评估热性惊厥患者复发和癫痫发生的风险因素。
Evaluation of the risk factors for recurrence and the development of epilepsy in patients with febrile seizure.
机构信息
University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Pediatrics, Bursa, Turkey.
University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Pediatric Neurology, Bursa, Turkey.
出版信息
Arq Neuropsiquiatr. 2022 Aug;80(8):779-785. doi: 10.1055/s-0042-1755202. Epub 2022 Oct 17.
BACKGROUND
Although febrile seizure (FS) is generally considered benign and self-limiting, there are differences regarding the risk factors, the prognosis, and the development of epilepsy.
OBJECTIVE
To examine the clinical and sociodemographic characteristics of patients diagnosed with FS, and to determine the risks of recurrence and the development of epilepsy.
METHODS
Between 2015 and 2019, we performed a retrospective evaluation of 300 patients with FS followed for at least 24 months.
RESULTS
The first episode of FS was simple in 72.7% of the patients and complex in 27.3%, and it recurred in 40%. Age under 12 months in the first FS, complex FS, and neurodevelopmental delay were found to statistically increase the risk of recurrence ( < 0.05). A total of 7% of the patients developed epilepsy, and this rate was found to be higher in patients with neurodevelopmental delay and long-term use of antiepileptic drugs ( < 0.001). The development of epilepsy was also observed in 77.8% of the patients with abnormal electroencephalogram (EEG). Epilepsy developed more frequently in those with abnormal EEG (<0.001).
CONCLUSIONS
Neurodevelopmental delay was an important risk factor for FS recurrence and the development of epilepsy. Abnormality in the EEG is an important risk factor for the development of epilepsy. We found that the long-term prophylactic treatment did not cause decreases in the recurrence of FS nor in the development of epilepsy.
背景
尽管热性惊厥（FS）通常被认为是良性和自限性的，但在危险因素、预后和癫痫发作方面存在差异。
目的
检查诊断为 FS 的患者的临床和社会人口统计学特征，并确定复发和癫痫发作的风险。
方法
在 2015 年至 2019 年期间，我们对至少随访 24 个月的 300 例 FS 患者进行了回顾性评估。
结果
首次 FS 发作中，单纯性占 72.7%，复杂性占 27.3%，复发率为 40%。首次 FS 年龄<12 个月、复杂性 FS 和神经发育迟缓被发现显著增加复发风险（<0.05）。共有 7%的患者发展为癫痫，而神经发育迟缓且长期使用抗癫痫药物的患者癫痫发生率更高（<0.001）。脑电图（EEG）异常的患者中也观察到 77.8%发展为癫痫。EEG 异常的患者癫痫发作更频繁（<0.001）。
结论
神经发育迟缓是 FS 复发和癫痫发作的重要危险因素。EEG 异常是癫痫发作的重要危险因素。我们发现长期预防治疗不会降低 FS 复发率和癫痫发生率。
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