Trittler-Ugidos I, Paredes-Carmona F, Vidiella-Rico G, Visa-Reñé N
Hospital Universitari Arnau de Vilanova de Lleida, Lleida, España.
Institut de Recerca Biomèdica Lleida, Lleida, España.
Rev Neurol. 2024 Oct 1;79(7):179-185. doi: 10.33588/rn.7907.2024243.
Given that febrile seizures are a common reason for both hospital and pre-hospital visits to physicians, and in the absence of a clear consensus on guidelines for treatment, especially for complex febrile seizures (CFS), we aim to examine their characteristics and treatment in order to improve the approach to the issue.
This is an observational, retrospective, single-centre study including paediatric patients seen after a seizure associated with a febrile illness in the emergency department of a second-level hospital between September 2021 and December 2023. Epidemiological, clinical and treatment variables were collected.
A total of 266 febrile seizures were included in the study: 188 (70.7%) were simple, and 78 (29.3%) were complex. Most benzodiazepines were administered during pre-hospital treatment (82%), and the transmucosal route was used in 70.3% of cases, despite the patient being in a healthcare environment. Complementary tests were performed in 70.6% of cases, blood tests in 65.6%, and nasopharyngeal swabs for viruses in 79.3%. A total of 73.6% of the tests requested were for patients with a focus of the fever.
Extensive use of complementary tests persists, despite the identification of a focus of the fever in most patients. Our results show that systematic complementary tests and the admission of patients who have presented a CFS would not be justified, and each individual case should be considered.
鉴于热性惊厥是医院和院前患者就诊于医生的常见原因,且在治疗指南方面缺乏明确共识,尤其是针对复杂性热性惊厥(CFS),我们旨在研究其特征和治疗方法,以改进对该问题的处理方式。
这是一项观察性、回顾性、单中心研究,纳入了2021年9月至2023年12月期间在一家二级医院急诊科因发热性疾病相关惊厥就诊的儿科患者。收集了流行病学、临床和治疗变量。
本研究共纳入266例热性惊厥患者:188例(70.7%)为单纯性,78例(29.3%)为复杂性。大多数苯二氮䓬类药物在院前治疗期间使用(82%),尽管患者处于医疗环境中,但70.3%的病例采用了经黏膜途径给药。70.6%的病例进行了辅助检查,65.6%进行了血液检查,79.3%进行了病毒鼻咽拭子检查。所要求检查的患者中,共有73.6%是针对有发热病灶的患者。
尽管大多数患者已确定发热病灶,但辅助检查仍被广泛使用。我们的结果表明,系统性辅助检查和收治出现CFS的患者并不合理,应考虑每个病例的具体情况。