van Stuijvenberg M, Steyerberg E W, Derksen-Lubsen G, Moll H A
Department of Pediatrics, Sophia Children's Hospital, Rotterdam, The Netherlands.
Arch Pediatr Adolesc Med. 1998 Dec;152(12):1170-5. doi: 10.1001/archpedi.152.12.1170.
Prediction of a recurrent febrile seizure during subsequent episodes of fever.
Study of the data of the temperatures, seizure recurrences, and baseline patient characteristics that were collected at a randomized placebo controlled trial of ibuprofen syrup to prevent febrile seizure recurrences.
Two pediatric hospitals in the Netherlands.
A total of 230 children with an increased risk of febrile seizure recurrence.
Seizure recurrence during a subsequent fever episode.
A total of 509 episodes of fever were registered with 67 recurrences; 35 (52%) recurrences within the first 2 hours after fever of onset had a lower median temperature (39.3 degrees C) than 32 (48%) after more than 2 hours of fever (40.0 degrees C, P<.001). Poisson regression analysis resulted in 3 univariably significant (P<.05) predictors of a recurrence of seizure during a subsequent episode of fever. In a multivariable model, they were corrected for their correlation: interval between the last previous seizure and fever of onset less than 6 months (relative risk= 1.3 [95% confidence interval: 0.8-2.4]), age at fever of onset (relative risk=0.7 [95% confidence interval: 0.5-1.0] per year increase) and temperature at fever of onset (relative risk = 1.7 [95% confidence interval: 1.1-2.8] per degree Celsius increase).
Half of the recurrent seizures occur in the first 2 hours after fever of onset of a subsequent fever episode. If seizure recurs at a later time, the temperature at seizure is higher compared with recurrences occurring in the first 2 hours of fever. Young age at fever of onset, high temperature at fever of onset, and high temperature during the episode of fever are associated with an increased risk of a recurrent febrile seizure at the moment that a child with a history of febrile seizures has fever again.
预测后续发热发作期间热性惊厥复发情况。
对布洛芬糖浆预防热性惊厥复发的随机安慰剂对照试验中收集的体温、惊厥复发及患者基线特征数据进行研究。
荷兰的两家儿科医院。
共230名热性惊厥复发风险增加的儿童。
后续发热发作期间的惊厥复发情况。
共记录到509次发热发作，其中67次复发；发热开始后2小时内的35次（52%）复发，其体温中位数（39.3摄氏度）低于发热超过2小时后的32次（48%）复发（40.0摄氏度，P<0.001）。泊松回归分析得出3个单变量对后续发热发作期间惊厥复发具有显著意义（P<0.05）的预测因素。在多变量模型中，对其相关性进行了校正：上次惊厥与发热开始之间的间隔少于6个月（相对风险=1.3 [95%置信区间：0.8 - 2.4]）、发热开始时的年龄（相对风险=0.7 [95%置信区间：0.5 - 1.0]，每增加一岁）以及发热开始时的体温（相对风险 = 1.7 [95%置信区间：1.1 - 2.8]，每升高一摄氏度）。
一半的惊厥复发发生在后续发热发作开始后的前2小时内。如果惊厥在较晚时间复发，与发热开始后前2小时内的复发相比，惊厥时的体温更高。发热开始时年龄小、发热开始时体温高以及发热期间体温高，与有热性惊厥病史的儿童再次发热时热性惊厥复发风险增加相关。
