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Evaluation of Children Admitted with Seizure

Year 2014, Volume: 2 Issue: 1, - , 23.03.2014

Abstract

Seizures; being the most common neurological problem in childhood, has an important ratio in the pediatric emergency department visits. It has been shown that 4-6% of children between 0-16 years of age; have a seizure in the life at least once. Because admissions due to seizure have a high ratio among all visits, it becomes an important problem in terms of economic and medical issue. In particular, path to be followed during the evaluation and selection of tests to be done in patients who admitted due to first seizure; poses a special importance. In this review; general approach to pediatric seizures and treatment in status epilepticus and febrile seizures are discussed.

 

Key words: Pediatric seizure, febrile convulsion, status epilepticus.

References

  • Chiang VW. Seizures. In: Fleisher GR, Ludwig S, eds. Textbook of Pediatric Emergency Medicine. 6th ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2010; 564-570.
  • Gülhan B, Tekşam Ö. Febril konvülziyon. Katkı Pediatri Dergisi. Hacettepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı ve Çocuk Sağlığı Enstitüsü Yayını. 2008 ;30: 767-774.
  • Swaiman KF, Ashwall S, Ferriero DM. Pediatric Neurology: Principles and Practice (4th ed.), London: Oxford University Press, 2010; 1037-1053.
  • Kaya Ü, Turanlı G. Status epileptikus. Katkı Pediatri Dergisi. Hacettepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı ve Çocuk Sağlığı Enstitüsü Yayını. 2008; 30: 749-766.
  • Sasidaran K, Singhi S, Singhi P. Management of acute seizure and status epilepticus in pediatric emergency. Indian J Pediatr 2012; 79: 510–517.
  • Holmes GL. Seizure-induced neuronal injury: animal data. Neurology 2002; 59: S3–6.
  • Hirtz D, Ashwal S, Berg A et al. Practice parameter: Evaluating a first nonfebrile seizure in children. Report of the Quality Standards Subcomittee of the American Academy of Neurology, the Child Society and the American Epilepsy Society. Neurology 2000; 55: 616-623.
  • Warden CR, Brownstein DR, Del Beccaro MA. Predictors of abnormal findings of computed tomography of the head in pediatric patients presenting with seizure. Ann Emerg Med 1997; 29: 518-523.
  • Chen CY, Chang YJ, Wu HP. New onset seizures in pediatric emergency. Pediatr Neonatol 2010; 51: 103−111.
  • Garvey MA, Gaillard WD, Rusin JA et al. Emergency brain computed tomography in children with seizures: Who is most likely to benefit? J Pediatr 1998; 133: 664-9.
  • Maytal J, Krauss JM, Novak G, Nagelberg J, Patel M. The role of brain computed tomography in evaluating children with new onset of seizures in the emergency department. Epilepsia, 2000; 41: 950-954.
  • Gaillard WD, Chiron C, Cross JH et al. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia 2009; 50: 2147–2153.
  • Raj D, Gulati S, Lodha R. Status epilepticus. Indian J Pediatr. 2011; 78: 219-26.
  • Friedman J. Emergency management of the paediatric patient with generalized convulsive status epilepticus. Canadian paediatric society, acute care committee. Paediatr Child Health 2011; 16: 91-97.
  • Sofou K, Kristjánsdóttir R, Papachatzakis NE, Ahmadzadeh A, Uvebrant P. Management of prolonged seizures and status epilepticus in childhood. J Child Neurol 2009; 24: 918-26.
  • Beghi E, Leone M, Solari A. Mortality in patients with a first unprovoked seizure. Epilepsia 2005;46 Suppl 11:40-2.
  • Prasad M, Krishnan PR, Sequeira R, Al-Roomi K. Anticonvulsant therapy for status epilepticus. Cochrane Database Syst Rev 2014 Sep 10;9:CD003723.
  • Appleton R, Sweeney A, Choonara I, Robson J, Molyneux E. Lorazepam versus diazepam in the acute treatment of epileptic seizures and status epilepticus. Dev Med Child Neurol 1995; 37: 682-8.
  • Mc Intyre J, Robertson S, Norris E et al. Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: A randomised controlled trial. Lancet 2005; 366: 205-10.
  • Scott BC, Besag FM, Neville BG. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: A randomised trial. Lancet 1999; 353: 623-6.
  • Mpimbaza A, Ndeezi G, Staedke S, Rosenthal PJ, Byarugaba J. Comparison of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in Ugandan children: A randomized clinical trial. Pediatrics 2008; 121: 58-64.
  • Chin RF, Neville BG, Peckham C, Wade A, Bedford H, Scott RC. Treatment of community-onset, childhood convulsive status epilepticus: A prospective, population-based study. Lancet Neurol 2008; 7: 696-703.
  • Yoong M, Chin RF, Scott RC. Management of convulsive status epilepticus in children. Arch Dis Child Educ Pract Ed 2009; 94: 1-9.
  • Ismail S, Levy A, Tikkanen H, Severe M, Woltes FJ, Carmant L et al. Lack of efficacy of phenytoin in children presenting with febrile status epilepticus. Am J Emerg Med 2012.
  • Guidelines for prolonged seizures and status epilepticus in infants (age > 1 month), children and adolescents. In: Lau E, ed. 2009/10 Drug Handbook and Formulary. Toronto: The Hospital for Sick Children, 2009: 322-4.
  • Febrile seizures: Guideline for the neurodiagnostic evaluation of the child with a simple febrile seizure. Subcommittee on febrile seizures, American Academy of Pediatrics. Pediatrics 2011;127;389-394.
  • Nur BG, Kahramaner Z, Duman O et al. Interleukin-6 gene polymorphism in febrile seizures. Pediatr Neurol 2012; 46: 36-8.
  • Oluwabusi T, Sood S. Update on the management of simple febrile seizures: emphasis on minimal intervention. Curr Opin Pediatr 2012; 24: 259–265.
  • Nelson K, Ellenberg J. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976; 295: 1029-1033.
  • Berg AT, Shinnar S. Complex febrile seizures. Epilepsia 1996; 37: 126-133.
  • Teng D, Dayan P, Tyler S et al. Risk of intracranial pathologic conditions requiring emergency intervention after a first complex febrile seizure episode among children. Pediatrics 2006; 117: 304-308.
  • DiMario F. Children presenting with complex febrile seizures do not routinely need computed tomography scanning in the emergency department. Pediatrics 2006; 117: 528-530.
  • Berg AT, Shinnar S, Hauser WA, Leventhal JM. Predictors of recurrent febrile seizures: a metaanalytic review. J Pediatr, 1990; 116: 329-37.
  • Kimia A, Ben-Joseph BP, Rudloe T et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics 2010; 126: 62-69.
  • Hom J, Medwid K. The low rate of bacterial meningitis in children, ages 6 to 18 months, with simple febrile seizures. Acad Emerg Med 2011; 18: 1114-20.
  • Carapetian S, Hageman J, Lyons E et al. Emergency Department Evaluation and Management of Children With Simple Febrile Seizures. Clin Pediatr (Phila) 2015 Feb 8. [Epub ahead of print]
  • Kimia A, Joseph E, Prabhu S et al. Yield of emergent neuroimaging among children presenting with a first complex febrile seizure. Pediatr Emer Care, 2012; 28: 316-321.

NÖBETLE BAŞVURAN ÇOCUK HASTAYA YAKLAŞIM

Year 2014, Volume: 2 Issue: 1, - , 23.03.2014

Abstract

Nöbet, çocukluk çağında görülen en sık nörolojik problem olup, çocuk acil servis başvurularının da önemli bir kısmını oluşturmaktadır. Yapılan çalışmalarda 0-16 yaş arasındaki çocukların %4-6’sının hayatında en az bir kere nöbet geçirdiği gösterilmiştir. Nöbet geçirme nedeniyle acil polikliniğine başvuran hastaların, tüm başvurular içinde büyük bir yer tutuyor olması da bu konuyu hem tıbbi hem de ekonomik açıdan önemli hale getirmektedir. Özellikle ilk kez nöbet geçirme nedeniyle başvuran hastalar; değerlendirme sırasında takip edailecek yol ve yapılması gereken tetkiklerin seçimi açısından ayrı bir önem arz etmektedir. Bu derlemede genel olarak pediatrik nöbete, status epileptikus ve febril konvülziyona yaklaşım ve tedavi üzerinde durulmuştur.

 

Anahtar kelimeler: Pediatrik nöbet, febril konvülziyon, status epileptikus.

References

  • Chiang VW. Seizures. In: Fleisher GR, Ludwig S, eds. Textbook of Pediatric Emergency Medicine. 6th ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2010; 564-570.
  • Gülhan B, Tekşam Ö. Febril konvülziyon. Katkı Pediatri Dergisi. Hacettepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı ve Çocuk Sağlığı Enstitüsü Yayını. 2008 ;30: 767-774.
  • Swaiman KF, Ashwall S, Ferriero DM. Pediatric Neurology: Principles and Practice (4th ed.), London: Oxford University Press, 2010; 1037-1053.
  • Kaya Ü, Turanlı G. Status epileptikus. Katkı Pediatri Dergisi. Hacettepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı ve Çocuk Sağlığı Enstitüsü Yayını. 2008; 30: 749-766.
  • Sasidaran K, Singhi S, Singhi P. Management of acute seizure and status epilepticus in pediatric emergency. Indian J Pediatr 2012; 79: 510–517.
  • Holmes GL. Seizure-induced neuronal injury: animal data. Neurology 2002; 59: S3–6.
  • Hirtz D, Ashwal S, Berg A et al. Practice parameter: Evaluating a first nonfebrile seizure in children. Report of the Quality Standards Subcomittee of the American Academy of Neurology, the Child Society and the American Epilepsy Society. Neurology 2000; 55: 616-623.
  • Warden CR, Brownstein DR, Del Beccaro MA. Predictors of abnormal findings of computed tomography of the head in pediatric patients presenting with seizure. Ann Emerg Med 1997; 29: 518-523.
  • Chen CY, Chang YJ, Wu HP. New onset seizures in pediatric emergency. Pediatr Neonatol 2010; 51: 103−111.
  • Garvey MA, Gaillard WD, Rusin JA et al. Emergency brain computed tomography in children with seizures: Who is most likely to benefit? J Pediatr 1998; 133: 664-9.
  • Maytal J, Krauss JM, Novak G, Nagelberg J, Patel M. The role of brain computed tomography in evaluating children with new onset of seizures in the emergency department. Epilepsia, 2000; 41: 950-954.
  • Gaillard WD, Chiron C, Cross JH et al. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia 2009; 50: 2147–2153.
  • Raj D, Gulati S, Lodha R. Status epilepticus. Indian J Pediatr. 2011; 78: 219-26.
  • Friedman J. Emergency management of the paediatric patient with generalized convulsive status epilepticus. Canadian paediatric society, acute care committee. Paediatr Child Health 2011; 16: 91-97.
  • Sofou K, Kristjánsdóttir R, Papachatzakis NE, Ahmadzadeh A, Uvebrant P. Management of prolonged seizures and status epilepticus in childhood. J Child Neurol 2009; 24: 918-26.
  • Beghi E, Leone M, Solari A. Mortality in patients with a first unprovoked seizure. Epilepsia 2005;46 Suppl 11:40-2.
  • Prasad M, Krishnan PR, Sequeira R, Al-Roomi K. Anticonvulsant therapy for status epilepticus. Cochrane Database Syst Rev 2014 Sep 10;9:CD003723.
  • Appleton R, Sweeney A, Choonara I, Robson J, Molyneux E. Lorazepam versus diazepam in the acute treatment of epileptic seizures and status epilepticus. Dev Med Child Neurol 1995; 37: 682-8.
  • Mc Intyre J, Robertson S, Norris E et al. Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: A randomised controlled trial. Lancet 2005; 366: 205-10.
  • Scott BC, Besag FM, Neville BG. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: A randomised trial. Lancet 1999; 353: 623-6.
  • Mpimbaza A, Ndeezi G, Staedke S, Rosenthal PJ, Byarugaba J. Comparison of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in Ugandan children: A randomized clinical trial. Pediatrics 2008; 121: 58-64.
  • Chin RF, Neville BG, Peckham C, Wade A, Bedford H, Scott RC. Treatment of community-onset, childhood convulsive status epilepticus: A prospective, population-based study. Lancet Neurol 2008; 7: 696-703.
  • Yoong M, Chin RF, Scott RC. Management of convulsive status epilepticus in children. Arch Dis Child Educ Pract Ed 2009; 94: 1-9.
  • Ismail S, Levy A, Tikkanen H, Severe M, Woltes FJ, Carmant L et al. Lack of efficacy of phenytoin in children presenting with febrile status epilepticus. Am J Emerg Med 2012.
  • Guidelines for prolonged seizures and status epilepticus in infants (age > 1 month), children and adolescents. In: Lau E, ed. 2009/10 Drug Handbook and Formulary. Toronto: The Hospital for Sick Children, 2009: 322-4.
  • Febrile seizures: Guideline for the neurodiagnostic evaluation of the child with a simple febrile seizure. Subcommittee on febrile seizures, American Academy of Pediatrics. Pediatrics 2011;127;389-394.
  • Nur BG, Kahramaner Z, Duman O et al. Interleukin-6 gene polymorphism in febrile seizures. Pediatr Neurol 2012; 46: 36-8.
  • Oluwabusi T, Sood S. Update on the management of simple febrile seizures: emphasis on minimal intervention. Curr Opin Pediatr 2012; 24: 259–265.
  • Nelson K, Ellenberg J. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976; 295: 1029-1033.
  • Berg AT, Shinnar S. Complex febrile seizures. Epilepsia 1996; 37: 126-133.
  • Teng D, Dayan P, Tyler S et al. Risk of intracranial pathologic conditions requiring emergency intervention after a first complex febrile seizure episode among children. Pediatrics 2006; 117: 304-308.
  • DiMario F. Children presenting with complex febrile seizures do not routinely need computed tomography scanning in the emergency department. Pediatrics 2006; 117: 528-530.
  • Berg AT, Shinnar S, Hauser WA, Leventhal JM. Predictors of recurrent febrile seizures: a metaanalytic review. J Pediatr, 1990; 116: 329-37.
  • Kimia A, Ben-Joseph BP, Rudloe T et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics 2010; 126: 62-69.
  • Hom J, Medwid K. The low rate of bacterial meningitis in children, ages 6 to 18 months, with simple febrile seizures. Acad Emerg Med 2011; 18: 1114-20.
  • Carapetian S, Hageman J, Lyons E et al. Emergency Department Evaluation and Management of Children With Simple Febrile Seizures. Clin Pediatr (Phila) 2015 Feb 8. [Epub ahead of print]
  • Kimia A, Joseph E, Prabhu S et al. Yield of emergent neuroimaging among children presenting with a first complex febrile seizure. Pediatr Emer Care, 2012; 28: 316-321.
There are 37 citations in total.

Details

Primary Language Turkish
Journal Section Reviews
Authors

Tuba Kasap

Publication Date March 23, 2014
Published in Issue Year 2014 Volume: 2 Issue: 1

Cite

Vancouver Kasap T. NÖBETLE BAŞVURAN ÇOCUK HASTAYA YAKLAŞIM. pediatr pract res. 2014;2(1).