Febril Konvülziyonlu Çocuklarda Risk Faktörlerinin Değerlendirilmesi

Year 2021, Volume: 5 Issue: 3, 213 - 217, 22.12.2021

Serdar Fidan , Erdal Ünlü , Ramazan Dulkadir , Ali Güneş

https://doi.org/10.46332/aemj.839714

Abstract

Amaç: Febril Konvülziyon çocukluk yaş grubunda en sık görülen nöbet şeklidir. Bu çalışma febril konvülziyon tanısıyla izlenen hastaların klinik özelliklerini araştırmak ve risk faktörlerini belirlemek amacıyla yapılmıştır.

Araçlar ve Yöntem: Febril konvülziyon tanısıyla Kırşehir Eğitim ve Araştırma Hastanesi Pediatri Servisinde takip edilen, 166 hasta çalışmaya alındı. Çalışmadaki veriler retrospektif olarak tıbbi kayıtlardan elde edildi. Hastalar yaş, cinsiyet, aile hikayesi, eş zamanlı biyokimya değerleri ve tam kan parametreleri açısından incelendi. Bu çalışma Kırşehir Ahi Evran Üniversitesi Tıp Fakültesi Klinik
Araştırmalar Etik Kurulu tarafından onaylandı.

Bulgular:131 hastada (%79) Basit Febril Konvülziyon ve 35 hastada (%21) Komplike Febril Konvülziyon mevcuttu. Etiyolojide en sık (%78) üst solunum yolu enfeksiyonu tanımlandı. Hastaların 27’sinde (%16) febril konvülziyon tekrarladı. Hastaların 37 ‘sinde (%22.2) ailede febril konvülziyon hikayesi, 14’ünde (%8.4) ailede epilepsi hikayesi mevcuttu. Febril konvülziyonlu hastalarda serum
sodyum, potasyum, klor, kalsiyum, trombosit düzeyleri kontrol grubuna göre anlamlı olarak düşük, glukoz, kreatin kinaz, C- reaktif protein düzeyi anlamlı yüksek saptandı (p<001).

Sonuç: Erken çocukluk döneminde, genetik yatkın olan hastalarda üst solunum yolu enfeksiyonları ve serum elektrolit bozuklukları febril konvülziyon için en önemli risk faktörleri olarak bulundu.

Keywords

elektrolit bozuklukları, febril konvülziyon, risk faktörleri

Supporting Institution

Kırşehir Ahi Evran Eğitim ve Araştırma Hastanesi

Project Number

2020-16/122

Evaluation of Risk Factors ın Children with Febrile Convulsions

Abstract

Purpose: Febrile Convulsions are the most common type of seizures in childhood. This study was conducted to investigate the clinical characteristics of patients being monitored for Febrile Convulsions and to determine their risk factors.

Materials and Methods: A total of 166 patients who were being treated in Kırşehir Training and Research Hospital Pediatrics service with the febrile convulsions diagnosis were included in the study. The data used in the study were obtained retrospectively from medical records. The patients were examined in terms of their age, gender, family history, simultaneous biochemistry values, and
complete blood count parameters. This study was approved by the Kırşehir Ahi Evran University Faculty of Medicine Clinical Research Ethics Committee.

Results: Simple Febrile Convulsions were present in 131 of the patients (79%) and Complicated Febrile Convulsions were present in 35 of them (21%). Upper respiratory tract infection was defined as the most common (78%) in the etiology. Febrile Convulsions recurred in 27 (16%) of the patients. There was a family history of Febrile Convulsions in 37 (22.2%) of the patients, and a family
history of epilepsy in 14 (8.4%). The serum sodium, potassium, chlorine, calcium, and platelet levels of patients with febrile convulsions were significantly lower than the control group, and the glucose, creatine kinase, C-reactive protein levels were significantly higher (P<001).

Conclusion: In early childhood, upper respiratory tract infections and serum electrolyte disturbances were found to be the most important risk factors for Febrile Convulsions for patients with a genetic predisposition.

Keywords

electrolyte disorders, febrile convulsions, risk factors

Project Number

2020-16/122

References

• 1. Duffner PK, Baumann RJ, Berman P, Green JL, Schneider S. American academy of pediatrics steering committee on quality ımprovement and management, subcommittee on febrile seizures. febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics. 2008;121(6):1281-1286.
• 2. Duffner PK, Berman PH, Baumann RJ, Fisher PG, Green JL, Schneider S. Subcommittee on febrile seizures; american academy of pediatrics. neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011;127(2):389-394.
• 3. Mewasingh LD. Febrile seizures. BMJ Clin Evid. 2010;2010:0324.
• 4. Smith DK, Sadler KP, Benedum M. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician. 2019;99(7):445-450.
• 5. Shabbir H, Tarar SH, Sabir MUD. Febrile seizrues: demographic, clinical and etiological profile of children admitted with febrile seizures in a tertiary care hospital. J Pak Med Assoc. 2015;65(9):1008- 1010.
• 6. Vestergaard M, Pedersen MG, Ostergaard JR, Pedersen CB, Olsen J, Christensen J. Death in children with febrile seizures: a population-based cohort study. Lancet. 2008;372(9637):457-463.
• 7. Shinnar S, Glauser TA. Febrile seizures. In: Pellock JM, Bourgeois BFD, Dodson WE. editors. Petiatric epilepsy. 3rd ed. New York: Demos Medical Publishing; 2008:293–305.
• 8. Gontko-Romanowska K, Żaba Z, Panieński P, et al. The assessment of risk factors for febrile seizures in children. J. Neurol Neurochir Pol. 2017;51(6):454-458.
• 9. Abuekteish F, Daoud AS, al-Sheyyab M, Nou’man M. Demographic characteristics and risk factors of first febrile seizures: a Jordanian experience. Trop Doct. 2000;30(1):25-27.
• 10. Ranthala H, Uhari M, Tarkka H. Viral infections and recurrences of febrile convulsions. J Pediatr. 1990;116(2):195-199.
• 11. Öztürk B, Nalbantoğlu B, Güzel EÇ, Hatipoğlu S, Nalbantoğlu A. Çocuk acil ünitesine febril konvülziyon tanısıyla başvuran beş ay-beş yaş arasındaki çocukların retrospektif olarak incelenmesi. Çocuk Dergisi. 2011;11(3):114-121.
• 12. Okumura A, Uemura N, Suzuki M, Itomi K, Watanabe K. Unconsciousness and delirious behavior in children with febrile seizures. Pediatr Neurol. 2004;30(5):316-319.
• 13. Wallace SJ. Febrile seizures. Epilepsia. 1996;2(1):28-33.
• 14. Yılmaz Ü, Özdemir R, Çelik T, Ataş E. Febril konvülziyonlu çocuklarda klinik ve paraklinik özellikler. Dicle Tıp Derg. 2014;41(1):156-162.
• 15. Ling SG. Febrile convulsions: Acute seizures characteristics and anti-convulsant therapy. Annals of Tropical Ped. 2000;20(3):227-230.
• 16. Shinnar S, Berg AT. Does antiepileptic drug therapy prevent the development of “chronic” epilepsy? Epilepsia. 1996;37(8):701-708.
• 17. Kölfen W, Pehle K, König S. Is the long-term outcome of children following febrile convulsions favorable? Dev Med Child Neurol. 1998;40(10):667-671.
• 18. Kılıç B. Clinical Features and Evaluation in Terms of Prophylaxis of Patients With Febrile Seizures. Sisli Etfal Hastan Tip Bul. 2019;53(3):276-283.
• 19. Teran CG, Medows M, Wong SH, Rodriguez L, Varghese R. Current role of the laboratory ınvestigation and source of the fever in the diagnostic. Approach Pediatr Emerg Care. 2012;28(6):493-497.
• 20. Pisacane A, Sansor R, Impagliazzo N. Iron deficieny and febrile convulsion. Case control study in children under 2 years. BMJ. 1996;313(7053):343.
• 21. Naveed-ur-Rehman M, Billoo AG. Association between iron deficiency anemia and febrile seizures. J Coll Phys Surg Pak. 2005;15(6):338-340.
• 22. Özaydın E, Arhan E, Cetinkaya B ve ark. Differences in iron deficiency anemia and mean platelet volume between childrenwith simple and complex febrile seizures, J. Seizure. 2012;21(3):211-214.
• 23. Liu Z, Li X, Zhang M, et al. The role of mean platelet volume/platelet count ratio and neutrophil to lymphocyte ratio on the risk of febrile seizure. Sci Rep. 2018;8(1):15123.
• 24. Nakayama, J, Arinami T, Molecular genetics of febrile seizures. Epilepsy research. 2006;70:190-198.
• 25. Nakayama, J. Progress in searching for the febrile seizure susceptibility genes. Brain Dev. 2009;31(5):359-365.
• 26. Scheffer IE, Nabbout R. SCN1A‐related phenotypes: Epilepsy and beyond. Epilepsia. 2019;60(3):17-24.
• 27. Mantegazza M, Broccoli V. SCN1A/NaV1.1 channelopathies: Mechanisms in expression systems, animal models, and human iPSC models. Epilepsia. 2019;60(3):25-38.
• 28. Chiarelli F, De Palma C, Verrotti A, Lombardi G, Domizio S. Electrolytic changes in febrile convulsions. Pediatr Med Chir. 1985;7(2):249-252.
• 29. Sumengen D, Silfeler I, Dorum BA ve ark. Çocuk Acil Polikliniğine Ateş ve Konvülziyon Şikayetiyle Başvuran Hastaların Lomber Ponksiyon ve Laboratuvar Bulguları Açısından Değerlendirilmesi. J Kartal TR. 2011;22 (1): 7-14.
• 30. Navaeifar MR, Abbaskhanian A, Farmanbarborji A. Relation between Febrile Seizure Recurrence and Hyponatremia in Children: A Single-center Trial. J Pediatr Neurosci. 2020;15(1):5-8.
• 31. Dilber B, Arslan EA, Şahin S, Esenülkü G, Kart PÖ, Cansu A. Febril nöbette hiponatreminin önemi. J. Curr. Pediatr. 2020;18(1):53-62.