Diurnal/Seasonal Rhythm of Febrile Convulsion

Öz

Objective: Febrile convulsion (FC) is a type of seizure that occurs with fever in children between 6-60 months. Melatonin, a neurohormone that exhibits diurnal and seasonal fluctuations, can reduce the frequency of seizures and show anticonvulsant effects by influencing the balance between excitatory and inhibitory neurotransmitters. The aim of this study is to determine the clinical characteristics of patients diagnosed with FC and to show the distribution of seizure frequency throughout the day and across seasons. Method: The study retrospectively examined the data of FC patients who presented to Ankara Yıldırım Beyazıt University Yenimahalle Training and Research Hospital Pediatric Emergency and Pediatric Neurology Clinic between 2014 and 2017. The patients’ age, gender, FC type, number of FCs, family history of epilepsy and FC, seizure time, and the month in which the seizure occurred were recorded. Results: The average age of the 409 FC patients included in the study was 27.7±14.9 months, with 67 patients (16%) being under 12 months of age. Male patients (58%) and those experiencing simple febrile convulsions (79%) were in the majority. Of the patients, 306 (75%) had a seizure only once. 296 (72%) of the FCs occurred between 08:00 and 19:59, and no significant relationship was found between the time range of FC occurrence, gender distribution, FC type, and the number of seizures. It was found that children under 12 months of age experienced more seizures during the night hours. Although the frequency of seizures was highest in the winter months, no significant seasonal difference was found. In all seasons, age, gender, FC type, and the number of recurrences were similar. Discussion: The information that the diurnal rhythm of melatonin may affect the frequency of nocturnal seizures provides important insights for the management of FC. However, the anticonvulsant effects of melatonin need to be studied in more detail.

Anahtar Kelimeler

• Diurnal Rhythm
• Febrile Convulsion
• Melatonin
• Seasonal Variation

Febril Konvülsiyonun Diurnal/Mevsimsel Ritmi

Öz

Amaç: Febril konvülsiyon (FK), 6-60 ay arasındaki çocuklarda ateşle birlikte görülen nöbetlerdir. Diurnal ve mevsimsel salınım gösteren bir nörohormon olan melatonin, eksitatör ve inhibitör nörotransmitter dengesini etkileyerek nöbetlerin sıklığını azaltıp antikonvülzan etki gösterebilir. Bu çalışmanın amacı FK tanısı alan hastalarımızın klinik özelliklerinin belirlenmesi ve nöbet sıklığının diurnal ve mevsimsel olarak dağılımının gösterilmesidir. Yöntem: Çalışmada, Ankara Yıldırım Beyazıt Üniversitesi Yenimahalle Eğitim Araştırma Hastanesi Çocuk Acil Servis ve Çocuk Nöroloji Polikliniklerine 2014-2017 yılları arasında başvuran FK hastalarının verileri geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, FK tipi, FK sayısı, ailede epilepsi ve FK öyküsü olup olmadığı, nöbet geçirme saati ve nöbet geçirdiği ay kaydedildi. Bulgular: Çalışmaya dahil edilen 409 FK hastasının yaş ortalaması 27,7±14,9 ay, 12 ayın altındaki hasta sayısı 67 (%16) idi. Erkek hastalar (%58) ve basit febril konvülsiyon (%79) geçiren hastalar çoğunluktaydı. Hastaların 306’sı (%75) sadece bir kez konvülsiyon geçirmişti. FK’ ların 296 (%72) tanesi saat 08:00-19:59 aralığında görüldü, FK görülme saat aralığı ile cinsiyet dağılımı, FK tipi ve FK sayısı arasında herhangi bir anlamlı ilişki görülmedi. 12 ay altındaki çocukların gece saatlerinde daha fazla nöbet geçirdiği gösterildi. Nöbet sıklığı en fazla kış aylarında olmasına rağmen mevsimsel olarak anlamlı bir farklılık saptanmadı. Tüm mevsimlerde yaş, cinsiyet, FK tipi ve tekrar sayısı benzerdi. Tartışma: Melatonin diurnal salınımının gece nöbet sıklığını etkileyebileceği bilgisi FK yönetimi için önemli bilgiler sunmaktadır. Ancak, melatoninin antikonvülzan etkisinin daha ayrıntılı şekilde incelenmesi gerekmektedir.

Anahtar Kelimeler

• Diurnal Ritim
• Febril Konvülsiyon
• Melatonin
• Mevsimsel Değişim

Kaynakça

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