Evaluation of Pediatric Patients with First Seizure

Yıl 2022, Cilt: 14 Sayı: 2, 411 - 414, 29.06.2022

Sevgi Çıraklı Hediye Usta Ali Aygun

https://doi.org/10.18521/ktd.1118913

Öz

Objective: Pediatric seizure is a condition that occurs due to many different underlying causes and causes fear and anxiety in families. In our study, it was aimed to evaluate pediatric seizure cases who applied to our hospital.
Material and Methods: Patients aged 0-18 years, who applied to the pediatric emergency department of our hospital between May 2018 and May 2020, were retrospectively analyzed. The patients were evaluated in terms of age, gender, seizure types, familial genetic predisposition, examination, treatment and follow-up. Seizures were divided into 2 groups as focal and generalized according to the International League Against Epilepsy (ILAE) 2017 classification. The treatment methods applied with cranial magnetic resonance imaging and electroencephalography recordings of the patients were evaluated.
Results: Of the 118 patients included in the study, 70 (59 %) were girls and 48 (41 %) were boys. The mean age was 60 (3-192) months. Family history was present in 18 (15 %) cases. 8 (7 %) of the seizures are partial and 110 (93 %) of them are generalized. Since seizure recurrence was observed within 24 hours in 5 of 36 patients who were evaluated as febrile seizures, they were evaluated as complicated febrile seizures and drug treatment was started. The other 31 patients were evaluated as simple febrile seizures. There was no biochemical abnormality in the seizure etiology in any of the cases. Cranial magnetic resonance imaging revealed polymicrogyria in 2 patients, hydrocephalus in 2 patients, brain tumor in 1 patient, and arteriovenous malformation in 1 patient.
Conclusions: In cases presenting with seizures, the underlying causes should be identified and their treatment should be arranged. Cases with recurrent seizures should also be followed closely.

Anahtar Kelimeler

Child, First Seizure, Treatment.

Çocuk Acile İlk Nöbet ile Başvuran Olguların Değerlendirilmesi

Öz

Amaç: Pediatrik nöbet, altındaki birçok farklı nedene bağlı oluşan ve ailelerde korku ile endişeye yol açan bir durumdur. Çalışmamızda hastanemize başvuran pediatrik nöbet olgularının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Mayıs 2018 ile Mayıs 2020 tarihleri arasında hastanemiz çocuk aciline nöbet ile başvuran 0-18 yaş arası hastalar retrospektif olarak incelendi. Hastalar yaş, cinsiyet, nöbet tipleri, ailesel genetik yatkınlık, tetkik, tedavi ve takip açısından değerlendirildi. Nöbetler International League Against Epilepsy (ILAE) 2017 sınıflamasına göre fokal ve jenaralize olarak 2 gruba ayrıldı. Hastaların kranial manyetik rezonans görüntüleme ve elektroensefalografi kayıtları ile uygulanan tedavi yöntemleri değerlendirildi.
Bulgular: Çalışmaya dahil edilen 118 hastanın 70 ‘i (%59) kız, 48’ i (%41) erkekti. Yaş ortalaması 60 (3-192) ay idi. Aile öyküsü 18 (% 15) olguda mevcuttu. Nöbetlerin 8’ i (% 7) parsiyel, 110’ u (% 93) jenaralize nöbetti. Febril nöbet olarak değerlendirilen 36 hastanın 5’ inde 24 saat içerisinde nöbet tekrarı görüldüğü için komplike febril nöbet olarak değerlendirilip ilaç tedavisi başlandı. Diğer 31 hasta basit febril nöbet olarak değerlendirildi. Nöbet etiyolojisinde hiçbir olguda biyokimyasal anormallik yoktu. Kranial manyetik rezonans görüntülemede 2 hastada polimikrogri, 2 hastada hidrosefali, 1 hastada beyin tümörü ve 1 hastada da arteriovenoz malformasyon saptandı.
Sonuç: Nöbet ile başvuran olgularda altta yatan nedenler tespit edilerek tedavileri düzenlenmelidir. Tekrarlayan nöbetleri olan olguların da yakın takibe alınması gerekmektedir.

Anahtar Kelimeler

Çocuk, İlk Nöbet, Tedavi

Kaynakça

• 1. Salman H, Olgaç Dündar N. The Evaluation and Follow-up Patients with First Seizure. Forbes J Med. 2022;3(1):18-23.
• 2. Pisani F, Spagnoli C, Falsaperla R, Nagarajan L. Seizure in the neonate: A review of etiologies and outcomes. Seizure: European Journal of Epilepsy. 2021;85:48-56.
• 3. Vasquez A, Farias-Moeller R, Tatum W. Pediatric refractory and süper-refractory status epilepticus. Seizure. 2019;68:62-71.
• 4. Laino D, Mencaroni E, Esposito S. Management of Pediatric Febrile Seizures. Int J Environ Res Public Health. 2018;15(2232):1-8.
• 5. Abend NS, Loddenkemper T. Pediatric Status Epilepticus Management.Curr Opin Pediatr. 2014;26(6):668-74.
• 6. Scheffer IE, Berkoviç S, Capovilla G, Connoly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: position paper of the ILAE commission for classification and terminology. Epilepsia. 2017;58:512-21.
• 7. Chang BS, Lowenstein DH. Epilepsy. N Engl J Med. 2003;349:1257-66.
• 8. Poduri A, Lewinstein D. Epilepsy genetics-Past, present, and future. Curr Opin Genet Dev. 2011;21:325-32.
• 9. Stafstrom CE, Carmant L. Seizures and Epilepsy: An Overwiew for Neuroscientsts. Cold Spring Harb Perspect Med. 2015;5:a022426.
• 10. Hamiwka LD, Singh N, Niosi J, Wirrell EC. Diagnostic inaccuracy in children referred with “first seizure”: role for a first seizure clinic. Epilepsia. 2007;48:1062-66.
• 11. Shinnar S, Berg AT, Moshe SL, O’Dell C,Alemany M, Newstein D, et al. The risk of seizure recurrence after a first unprovoked afebrile seizure in childhood: an extended follow-up. Pediatrics. 1996;98:216-225.
• 12. Okumura A, Ishiguro Y, Sofue A. Treatment and outcome in patients with febrile convulsion associated with epileptiform discharges on electroencephalography. Brain Dev. 2004;26:241-4.
• 13. Ling SG. Febrile convulsions: acute seizure characteristics and anti-convulsant therapy. Ann Trop Paediatr. 2000;20:227-30.
• 14. Russ SA, Larson K, Halfon N. A national prolife of childhood epilepsy and seizure disorder. Pediatrics. 2012;129:256.
• 15. Camfield PR, Camfield CS, Dooley JM, Tibbles JA, Fung T, Garner B. Epilepsy after a first unprovoked seizure in childhood. Neurology. 1985;35:1657-60.
• 16. O’Dell C, Shinner S. Initiation and discontinuation of antiepileptic drugs. Neurologic Clinics. 2001;19(2):289.
• 17. Anjcllin M. Antiepilectic drug treatment of epilepsy in children. 2019;25(2):381-407.
• 18. Dudley RWR, Penney SJ, Buckley DJ. First-Drug Treatment Failures in Children Newly Diagnosed With Epilepsy. Pediatric Neurology. 2009;40(2):71-7.