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Febril Konvülziyonlu 1385 Vakanın Klinik Özellikleri ve Risk Faktörleri

Year 2011, Volume: 5 Issue: 1, 11 - 18, 01.12.2011

Abstract

Giriş-Amaç: Febril konvülziyon (FK) 3 ay ve 5 yaş arasında görülen ve çocukları % 2-5 oranında etkileyen çocukluk çağının en sık görülen nöbet şeklidir. Çalışmamızın amacı febril konvülziyonla izlenen hastaların klinik özelliklerini araştırmak ve risk faktörlerini belirlemektir.Olgular ve Metod: Pediatrik Nöroloji Departmanında izlenen 1385 hasta çalışmaya dahil edilmiştir. Hastalarla ilgili veriler tıbbi kayıtlardan sağlanmıştır.Bulgular: Hastaların ortalama yaşı 22.2±1.24 aydı. % 59.3 ile erkekler çoğunluktaydı. 1245 (% 89.8) hastada basit FK ve 140 (% 10.2) hastada komplike FK mevcuttu. Hastaların nöbet esnasında rektal olarak ölçülen ortalama vücut sıcaklıkları 39.2±0.6ºC’di. Dört yüz yirmi sekiz (% 30.9) hastada enfeksiyöz hastalık tanımlandı. En sık tanımlanan enfeksiyon viral üst solunum yolu enfeksiyonuydu. Hastaların 568’inde (% 41.1) febril nöbet ve 26’sında (% 1.87) afebril konvülziyon tekrarladı. Yedi yüz doksan altı (% 57.4) hastanın ailesinde FK öyküsü mevcuttu. Komplikefebril konvülziyonu olan 4 hastanın EEG’sinde anormal bulgular saptandı. Basit veya komplike FK’u olan vakalara fenobarbital veya rektal diazepam profilaktik antiepileptik tedavi olarak başlandı.Sonuç: Nöbetlerin başlangıç yaşı ve ailede febril konvülziyon öyküsü nöbetlerin tekrarı açısından en güçlü risk faktörleri olarak bulundu. Ailelerin risk faktörleri ve prognozla ilgili olarak bilgilendirilmesinin anksiyete düzeylerinin azaltılması ve gereksiz profilaktik tedavilerin önlenmesi bakımından önemli olduğu düşünüldü.

References

  • Hauser WA. The prevalance and incidence of convulsive disorders in children. Epilepsia 1994;35:1-6.
  • Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr 2008;167(1):17-27.
  • Offringa M, Hazebroek-Kampschreur AA, Derksen-Lubsen G. Prevalance of febrile seizures in Dutch school children. Paediatr Perinatal Epidemiol 1991;5(2):181-8.
  • Nakayama J, Arinami T. Molecular genetics of febrile seizures. Epilepsy Res 2006;70:190-8.
  • Nakayama J. Progress in searching for the febrile seizure suscepti- bility genes. Brain Dev 2009;31(5):359-65.
  • Berg AT. Febrile seizures and epilepsy: The contributions of epide- miology. Paediatr Perinat Epidemiol 1992;6(2):145-52.
  • Tsuboi T. Epidemiology of febrile and afebrile convulsions in chil- dren in Japan. Neurology 1984;34(2):175-81.
  • Tsuboi T. Genetic analysis of febrile convulsions.Twin and family studies. Hum Genet 1987;75(1):7-14.
  • Van Esch A, Steyerberg EW, Berger M. Family history and recur- rence of febrile seizures. Arch Dis Child 1994;70(5):395-9.
  • Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognos- tic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316(9):493-8.
  • Aygün AD, Güvenç H, Koç A, Şükür Ç, Kocabay K. İlk febril konvülziyon:169 olgunun değerlendirilmesi. Turkiye Klinikleri J Pediatr 1995;4(1):19-9.
  • Yılmaz E, Doğan Y, Gürgöze M, Aygün AD. Febril konvülziyon ve rekürens risk faktörlerinin değerlendirilmesi. Turkiye Klinikleri J Pediatr 1999;8(4):214-8.
  • Şen Y, Şengül İ, Arslan N, Kabakuş N. Febril konvülziyonlar: 265 olgunun analizi. Turkiye Klinikleri J Pediatr 2008;17(2):75-9.
  • Hauser WA, Annegers JF, Anderson VE, Kurland LT. The risk of seizure disorders among relatives of children with febrile convul- sions. Neurology. 1985;35(9):1268-73.
  • Lahat E, Livne M, Barr J, Katz Y. Interleukin-1beta levels in serum and cerebrospinal fluid of children with febrile seizures. Pediatr Neurol 1997;17(1):34-6.
  • Haspolat S, Baysal Y, Duman O, Coskun M, Tosun O, Yegin O. Interleukin-1alfa, interleukin-1beta and interleukin-1Ra polymor- phisms in febrile seizures. J Child Neurol 2005;20(7):565-8.
  • Offringa M, Bossuyt PM, Lubsen J, Ellenberg JH, Nelson KB, Knudsen FU, et al. Risk factors for seizure recurrence in children with febrile seizures: A pooled analysis of individual patient data from five studies. J Pediatr 1994;124(4):574-84.
  • Berg AT, Shinnar S, Darefsky AS, Holford TR, Shapiro ED, Salo- mon ME, et al. Predictors of recurrent febrile seizures. A prospec- tive cohort study. Arch Pediatr Adolesc Med 1997;151(4):371-8.
  • Wairuiru C, Appleton R. Febrile seizures: An update. Arch Dis Child 2004;89(8):751-6.
  • Knudsen FU. Febrile seizure: Treatment and prognosis. Epilepsia 2000;41(1):2-9.
  • Knudsen FU. Recurrence risk after first febrile seizure and effect of short term diazepam prophylaxis. Arch Dis Child 1985;60(1):1045-9.
  • Tosun A, Koturoglu G, Serdaroglu G, Polat M, Kurugol Z, Gokben S, et al. Ratios of nine risk factors in children with recurrent febrile seizures. Pediatr Neurol 2010;43(3):177-82.
  • Baumann RJ, Duffner PK. Treatment of children with simple fe- brile seizures: the AAP practice parameter. American Academy of Pediatrics. Pediatr Neurol 2000;23(1):11-7.
  • El-Radhi AS, Barry W. Do antipyretics prevent febrile convul- sions? Arch Dis Child 2003; 88(7):641-2.
  • Wheless JW, Clarke DF, Carpenter D. Treatment of pediatric epi- lepsy: Expert opinion, 2005. J Child Neurol 2005;20:1-56.
  • Baumann RJ. Technical report: treatment of the child with simple febrile seizures. Pediatrics 1999;103(6):e86
  • Deda G, Karagöl U, Uysal S, Güven A. Febrile convulsions: Re- view of 284 patients and the evaluation of intermittent prophylaxis. Journal of Ankara Medical School 1999;21(2):61-4.

THE CLINICAL CHARACTERISTICS AND RISK FACTORS OF 1385 CASES WITH FEBRILE CONVULSION

Year 2011, Volume: 5 Issue: 1, 11 - 18, 01.12.2011

Abstract

Introduction-Aim: Febrile convulsions (FC) are the most common form of childhood seizures affecting 2-5% of all children and usually appearing between 3 months and 5 years of age. The aim of our study was to investigate the clinical characteristics and risk factors of the patients with FC.Method: A total of 1385 patients followed-up for FC in Pediatric Neurology Department were included in the study. Data regarding the patients was obtained from the medical records. Results: The mean age of the patients was 22.2±1.24 months. A male preponderance (59.3%) was found. Among 1385 patients with FC, 1245 had simple and 140 had complex FC. The mean temperature of the patients measured rectally during the seizure was 39.2±0.6 ºC. The infectious disease was identified in 428 (30.9%) cases. The most commonly diagnosed infection ( 216 patients ) was viral upper respiratory tract infection. The recurrence of FC occured in 568 (41.1%) and afebrile convulsion developed in 26 (1.87%) patients. There was a family history of FC in 796 patients. Four patients with complex FC had abnormal findings on EEG. The prophylactic antiepileptic medication of phenobarbital or rectal diazepam was initiated in children with simple or complex FC. Conclusion: Age onset and family history of FC were found as the strongest risk factors for the recurrence of FC. To inform the families about the risk factors and prognosis of the disease is very important to reduce the anxiety level and prevent unnecessary prophylactic treatments

References

  • Hauser WA. The prevalance and incidence of convulsive disorders in children. Epilepsia 1994;35:1-6.
  • Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr 2008;167(1):17-27.
  • Offringa M, Hazebroek-Kampschreur AA, Derksen-Lubsen G. Prevalance of febrile seizures in Dutch school children. Paediatr Perinatal Epidemiol 1991;5(2):181-8.
  • Nakayama J, Arinami T. Molecular genetics of febrile seizures. Epilepsy Res 2006;70:190-8.
  • Nakayama J. Progress in searching for the febrile seizure suscepti- bility genes. Brain Dev 2009;31(5):359-65.
  • Berg AT. Febrile seizures and epilepsy: The contributions of epide- miology. Paediatr Perinat Epidemiol 1992;6(2):145-52.
  • Tsuboi T. Epidemiology of febrile and afebrile convulsions in chil- dren in Japan. Neurology 1984;34(2):175-81.
  • Tsuboi T. Genetic analysis of febrile convulsions.Twin and family studies. Hum Genet 1987;75(1):7-14.
  • Van Esch A, Steyerberg EW, Berger M. Family history and recur- rence of febrile seizures. Arch Dis Child 1994;70(5):395-9.
  • Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognos- tic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316(9):493-8.
  • Aygün AD, Güvenç H, Koç A, Şükür Ç, Kocabay K. İlk febril konvülziyon:169 olgunun değerlendirilmesi. Turkiye Klinikleri J Pediatr 1995;4(1):19-9.
  • Yılmaz E, Doğan Y, Gürgöze M, Aygün AD. Febril konvülziyon ve rekürens risk faktörlerinin değerlendirilmesi. Turkiye Klinikleri J Pediatr 1999;8(4):214-8.
  • Şen Y, Şengül İ, Arslan N, Kabakuş N. Febril konvülziyonlar: 265 olgunun analizi. Turkiye Klinikleri J Pediatr 2008;17(2):75-9.
  • Hauser WA, Annegers JF, Anderson VE, Kurland LT. The risk of seizure disorders among relatives of children with febrile convul- sions. Neurology. 1985;35(9):1268-73.
  • Lahat E, Livne M, Barr J, Katz Y. Interleukin-1beta levels in serum and cerebrospinal fluid of children with febrile seizures. Pediatr Neurol 1997;17(1):34-6.
  • Haspolat S, Baysal Y, Duman O, Coskun M, Tosun O, Yegin O. Interleukin-1alfa, interleukin-1beta and interleukin-1Ra polymor- phisms in febrile seizures. J Child Neurol 2005;20(7):565-8.
  • Offringa M, Bossuyt PM, Lubsen J, Ellenberg JH, Nelson KB, Knudsen FU, et al. Risk factors for seizure recurrence in children with febrile seizures: A pooled analysis of individual patient data from five studies. J Pediatr 1994;124(4):574-84.
  • Berg AT, Shinnar S, Darefsky AS, Holford TR, Shapiro ED, Salo- mon ME, et al. Predictors of recurrent febrile seizures. A prospec- tive cohort study. Arch Pediatr Adolesc Med 1997;151(4):371-8.
  • Wairuiru C, Appleton R. Febrile seizures: An update. Arch Dis Child 2004;89(8):751-6.
  • Knudsen FU. Febrile seizure: Treatment and prognosis. Epilepsia 2000;41(1):2-9.
  • Knudsen FU. Recurrence risk after first febrile seizure and effect of short term diazepam prophylaxis. Arch Dis Child 1985;60(1):1045-9.
  • Tosun A, Koturoglu G, Serdaroglu G, Polat M, Kurugol Z, Gokben S, et al. Ratios of nine risk factors in children with recurrent febrile seizures. Pediatr Neurol 2010;43(3):177-82.
  • Baumann RJ, Duffner PK. Treatment of children with simple fe- brile seizures: the AAP practice parameter. American Academy of Pediatrics. Pediatr Neurol 2000;23(1):11-7.
  • El-Radhi AS, Barry W. Do antipyretics prevent febrile convul- sions? Arch Dis Child 2003; 88(7):641-2.
  • Wheless JW, Clarke DF, Carpenter D. Treatment of pediatric epi- lepsy: Expert opinion, 2005. J Child Neurol 2005;20:1-56.
  • Baumann RJ. Technical report: treatment of the child with simple febrile seizures. Pediatrics 1999;103(6):e86
  • Deda G, Karagöl U, Uysal S, Güven A. Febrile convulsions: Re- view of 284 patients and the evaluation of intermittent prophylaxis. Journal of Ankara Medical School 1999;21(2):61-4.
There are 27 citations in total.

Details

Other ID JA94MK56RH
Journal Section Research Article
Authors

Eda Özaydın This is me

Mehmet Zeki Yaşar This is me

Alev Güven This is me

Aydan Değerliyurt This is me

Sadi Vidinlisan This is me

Gülşen Köse This is me

Publication Date December 1, 2011
Submission Date December 1, 2011
Published in Issue Year 2011 Volume: 5 Issue: 1

Cite

Vancouver Özaydın E, Yaşar MZ, Güven A, Değerliyurt A, Vidinlisan S, Köse G. THE CLINICAL CHARACTERISTICS AND RISK FACTORS OF 1385 CASES WITH FEBRILE CONVULSION. Türkiye Çocuk Hast Derg. 2011;5(1):11-8.


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