Demographic and clinical characteristics of children who were hospitalized and followed due to seizures

Year 2020, Volume: 4 Issue: 7, 545 - 549, 01.07.2020

Ozan Koçak , Füsun Dilara İçağasıoğlu

https://doi.org/10.28982/josam.773784

Cited By: 1

Abstract

Aim: Seizure is the most common neurological disorder of childhood. The causes of seizures in childhood, especially febrile convulsions (FC), is still not fully elucidated. In addition, diagnosis, follow-up and treatment are still controversial. In this study, we aimed to investigate the clinical/demographic features, laboratory results, electroencephalography and neuroimaging findings of children who were hospitalized and followed due to seizures.
Methods: This retrospective cohort study included 737 patients who were hospitalized and followed up due to seizures in the pediatric neurology department. Clinical features and laboratory results of the patients were evaluated.
Results: Among all, 53.1% of the patients who had febrile convulsions were males, 46.9% were females, and the mean age was 20.68 (5) months. The most important risk factors in febrile convulsion were positive family history (38.4%) and iron deficiency (42.9%). The most common source of infection was viral upper respiratory tract infections. While cerebrospinal fluid evaluations were normal in patients with ordinary febrile convulsions, that of 30 patients with complex febrile convulsions were coherent with meningitis. 437 patients were hospitalized with the diagnosis of epilepsy, among which 54.3% were males, and 45.7% were females. The mean age was 65.8 (54.8) months. Generalized tonic-clonic seizures were most common, while idiopathic epilepsy was the most frequently observed type. The most common risk factors in epilepsy patients were positive family history (26.2%), febrile convulsion (26.8%), and cerebral palsy (8.2%).
Conclusion: In this study, febrile convulsion and idiopathic epilepsy were the most determined causes of pediatric convulsion. Kinship marriage and positive family history are both the most important risk factors in febrile convulsions and epilepsy. Children with focal FC should be followed closely due to increased risk of epilepsy. 

Keywords

Febrile convulsion, Seizure, Epilepsy

Nöbet nedeni ile yatırılan ve takip edilen çocuk hastaların demografik ve klinik özellikleri

Abstract

Amaç: Nöbet, çocukluk çağının en sık görülen nörolojik bozukluğudur. Çocukluk çağında nöbetlerin, özellikle febril konvülsiyonların nedenleri hala tam olarak aydınlatılamamıştır. Ayrıca tanı, takip ve tedavi halen tartışmalıdır. Bu çalışmada, nöbet nedeniyle hastaneye yatırılan ve takip edilen çocukların klinik özellikleri, laboratuvar sonuçları, elektroensefalografi ve beyin görüntüleme bulguları, tedavi yöntemleri ve demografik özelliklerinin araştırılması amaçlandı.
Yöntemler: Bu retrospektif kohort çalışmaya pediatrik nöroloji servisinde nöbet nedeniyle yatırılarak takip edilen 737 hasta dahil edilmiştir. Hastaların klinik özellikleri ve laboratuvar sonuçları retrospektif olarak değerlendirildi.
Bulgular: Hastaların 245’i febril konvülziyon, 437’si epilepsiydi. Febril konvülziyon geçiren hastaların %53,1’i erkek, %46,9’u kız, ortalama yaşları 20,6(5)aydı. Febril konvülziyon hastalarında en önemli risk faktörleri pozitif aile öyküsü(%38,4) ve demir eksikliği(%42,9) olarak belirlendi. En sık saptanan enfeksiyon kaynağı viral üst solunum yolu enfeksiyonlarıydı. Basit febril konvülziyon geçiren hastalarda beyin omurilik sıvısı değerlendirmeleri normalken, komplike febril konvülziyon geçiren 30 hastada menenjit ile uyumluydu. Epilepsi tanısı ile 437 hasta yatırılmıştı. Epilepsi hastalarının %54,3’ü erkek %45,7’si kadındı ve yaş ortalaması 65,8 (54,8) aydı. En sık jeneralize tonik klonik nöbetler görülmüştü ve en sık epilepsi tipi idiyopatik epilepsiydi. Epilepsi hastalarında en sık risk faktörleri pozitif aile öyküsü (%26,2), febril konvülziyon geçirme (%26,8) ve serebral palsiydi (%8,2).
Sonuç: Bu çalışmada çocukluk çağı nöbetlerinde en sık saptanan etiyolojik nedenler febril konvülziyon ve idiyopatik epilepsidir. Akraba evlilikleri ve pozitif aile öyküsü hem febril konvülziyonlarda, hem de epilepsi de en önemli risk faktörleridir. Fokal febril konvülziyon geçiren hastaların epilepsi gelişimi açısından yakın takibe alınmalıdır. 

Keywords

Febril konvülsiyon, Nöbet, Epilepsi

References

• 1. Rosenbloom E, Finkelstein Y, Adams-Webber T, Kozer E. Do antipyretics prevent the recurrence of febrile seizures in children? A systematic review of randomized controlled trials and meta-analysis. Eur J Paediatr Neurol. 2013;17(6):585-8. doi:10.1016/j.ejpn.2013.04.008
• 2. Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr. 2008;167(1):17-27. doi:10.1007/s00431-007-0577-x
• 3. Shinnar S, O'Dell C. Febrile seizures. Pediatr Ann. 2004;33(6):394-401. doi:10.3928/0090-4481-20040601-10
• 4. Hauser WA. Epidemiology of epilepsy in children. In: Pellock JM, Dodson WE, Bourgeois BFD, eds. Pediatric Epilepsy: Diagnosis and Therapy, 2nd ed. New York: Demos Medical Publishing, Inc. 2001:81–96.
• 5. Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-82. doi: 10.1111/epi.12550. Epub 2014 Apr 14. PMID: 24730690.
• 6. Özaydın E, Yaşar MZ, Güven A, Değerliyurt A, Vidinlisan S, Köse G. Febril konvülziyonlu 1385 vakanın klinik özellikleri ve risk faktörleri. Türkiye Çocuk Hast Derg. 2011;5:11-8.
• 7. Aydın ÖF, Şenbil N, Kara C, Bozkurt C, Gürer YKY. Febril konvülziyonlu 201 hastanın retrospektif olarak değerlendirilmesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2000;53:231-5.
• 8. Yılmaz Ü, Özdemi̇r R, Çeli̇k T, Berksoy E. Clinical and paraclinical features in children with febrile seizures. Dicle Tıp Dergisi. 2014;41(1):156-62. doi: 10.5798/diclemedj.0921.2014.01.0391
• 9. Okumura A, Ishiguro Y, Sofue A, Suzuki Y, Maruyama K, Kubota T, et al. Treatment and outcome in patients with febrile convulsion associated with epileptiform discharges on electroencephalography. Brain Dev. 2004;26(4):241-4. doi: 10.1016/S0387-7604(03)00161-X. PMID: 15130690.
• 10. Manfredini R, Vergine G, Boari B, Faggioli R, Borgna-Pignatti C. Circadian and seasonal variation of first febrile seizures. J Pediatr. 2004;145(6):838-9. doi: 10.1016/j.jpeds.2004.06.079. PMID: 15580213.
• 11. Bessisso MS, Elsaid MF, Almula NA, Kadomi NK, Zeidan SH, Azzam SB, et al. Recurrence risk after a first febrile convulsion. Saudi Med J. 2001;22(3):254-8. PMID: 11307113.
• 12. Piperidou HN, Heliopoulos IN, Maltezos ES, Stathopoulos GA, Milonas IA. Retrospective study of febrile seizures: subsequent electroencephalogram findings, unprovoked seizures and epilepsy in adolescents. J Int Med Res. 2002;30(6):560-5. doi: 10.1177/147323000203000603. PMID: 12526282.
• 13. Shinnar S, Glauser TA. Febrile seizures. J Child Neurol. 2002;17 Suppl 1:S44-52. doi: 10.1177/08830738020170010601. PMID: 11918463.
• 14. Subcommittee on Febrile Seizures; American Academy of Pediatrics. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011;127(2):389-94. doi: 10.1542/peds.2010-3318. PMID: 21285335.
• 15. Casasoprana A, Hachon Le Camus C, Claudet I, Grouteau E, Chaix Y, Cances C, et al. Utilité de la ponction lombaire lors de la première convulsion fébrile chez l'enfant de moins de 18 mois. Étude rétrospective de 157 cas [Value of lumbar puncture after a first febrile seizure in children aged less than 18 months. A retrospective study of 157 cases]. Arch Pediatr. 2013;20(6):594-600. French. doi: 10.1016/j.arcped.2013.03.022. Epub 2013 Apr 30. PMID: 23639837.
• 16. Britton PN, Blyth CC, Macartney K, Dale RC, Li-Kim-Moy J, Khandaker G, et al. Australian Childhood Encephalitis (ACE) Study Investigators, Influenza Complications Alert Network (FluCAN) Investigators, and Paediatric Active Enhanced Disease Surveillance (PAEDS) Network. The Spectrum and Burden of Influenza-Associated Neurological Disease in Children: Combined Encephalitis and Influenza Sentinel Site Surveillance From Australia, 2013-2015. Clin Infect Dis. 2017;65(4):653-660. doi: 10.1093/cid/cix412. PMID: 29017268.
• 17. Chiu SS, Tse CY, Lau YL, Peiris M. Influenza A infection is an important cause of febrile seizures. Pediatrics. 2001;108(4):E63. doi: 10.1542/peds.108.4.e63. PMID: 11581471.
• 18. Carman KB, Calik M, Karal Y, Isikay S, Kocak O, Ozcelik A, et al. Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study). Hum Vaccin Immunother. 2019;15(2):496-502. doi: 10.1080/21645515.2018.1526588. Epub 2018 Oct 5. PMID: 30235060; PMCID: PMC6422444.
• 19. Naveed-ur-Rehman, Billoo AG. Association between iron deficiency anemia and febrile seizures. J Coll Physicians Surg Pak. 2005;15(6):338-40. PMID: 15924837.
• 20. Daoud AS, Batieha A, Abu-Ekteish F, Gharaibeh N, Ajlouni S, Hijazi S. Iron status: a possible risk factor for the first febrile seizure. Epilepsia. 2002;43(7):740-3. doi: 10.1046/j.1528-1157.2002.32501.x. PMID: 12102677.
• 21. Ünver O, Sezer RG, Kibar AE, Ünver A, İpek İÖ, Bozaykut A. The association between febrile seizures and iron deficiency anemia in childhood. J Clin Anal Med. 2015;6(1):57-60.
• 22. Baumann RJ, Duffner PK. Treatment of children with simple febrile seizures: the AAP practice parameter. American Academy of Pediatrics. Pediatr Neurol. 2000;23(1):11-7. doi: 10.1016/s0887-8994(00)00148-x. PMID: 10963965.
• 23. Deda G, Karagöl U, Uysal S, Güven A. Febrile convulsions: Review of 284 patients and the evaluation of intermittent prophylaxis. Journal of Ankara Medical School. 1999;21:61-4.
• 24. Forsgren L, Beghi E, Oun A, Sillanpää M. The epidemiology of epilepsy in Europe - a systematic review. Eur J Neurol. 2005;12(4):245-53. doi: 10.1111/j.1468-1331.2004.00992.x. PMID: 15804240.
• 25. Winckler MI, Rotta NT. Clinical and electroencephalographic follow-up after a first unprovoked seizure. Pediatr Neurol. 2004;30(3):201-6. doi: 10.1016/j.pediatrneurol.2003.08.002. PMID: 15033203.
• 26. Benna P, Ferrero P, Bianco C, Asteggiano G, Pinessi L. Epidemiological aspects of epilepsy in the children of a Piedmontese district (Alba-Bra). Panminerva Med. 1984;26(2):113-8. PMID: 6483458.
• 27. Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde Boas W, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010;51(4):676-85. doi: 10.1111/j.1528-1167.2010.02522.x. Epub 2010 Feb 26. PMID: 20196795.
• 28. Yaman M, Şahin Ş, Yeni S.N. Karaağaç N. Sporadik ve ailevi epilepsilerde etiyolojik risk faktörü karşılaştırması. Fırat Tıp Dergisi. 2007;12(2):121-3.
• 29. Kwong KL, Chak WK, Wong SN, So KT. Epidemiology of childhood epilepsy in a cohort of 309 Chinese children. Pediatr Neurol. 2001;24(4):276-82. doi: 10.1016/s0887-8994(01)00247-8. PMID: 11377102.
• 30. Asadi-Pooya AA, Hojabri K. Risk factors for childhood epilepsy: a case-control study. Epilepsy Behav. 2005;6(2):203-6. doi: 10.1016/j.yebeh.2004.11.018. PMID: 15710305.
• 31. Nelson KB, Ellenberg JH. Antecedents of seizure disorders in early childhood. Am J Dis Child. 1986;140(10):1053-61. doi: 10.1001/archpedi.1986.02140240099034. PMID: 3752015.
• 32. Aydin A, Ergor A, Ergor G, Dirik E. The prevalence of epilepsy amongst school children in Izmir, Turkey. Seizure. 2002;11(6):392-6. doi: 10.1053/seiz.2002.0684. PMID: 12160669.
• 33. Christensen J, Pedersen MG, Pedersen CB, Sidenius P, Olsen J, Vestergaard M. Long-term risk of epilepsy after traumatic brain injury in children and young adults: a population-based cohort study. Lancet. 2009;28:373(9669):1105-10. doi: 10.1016/S0140-6736(09)60214-2. Epub 2009 Feb 21. PMID: 19233461.
• 34. Verity CM, Golding J. Risk of epilepsy after febrile convulsions: a national cohort study. BMJ. 1991;30;303(6814):1373-6. doi: 10.1136/bmj.303.6814.1373. Erratum in: BMJ 1992 Jan 18;304(6820):147. PMID: 1760604; PMCID: PMC1671614.
• 35. Vestergaard M, Pedersen CB, Sidenius P, Olsen J, Christensen J. The long-term risk of epilepsy after febrile seizures in susceptible subgroups. Am J Epidemiol. 2007;165(8):911-8. doi: 10.1093/aje/kwk086. Epub 2007 Jan 30. PMID: 17267419.
• 36. Baumer JH. "Paediatric Accident and Emergency Research Group". Evidence based guideline for post-seizure management in children presenting acutely to secondary care. Arch Dis Child. 2004;89(3):278-80. doi: 10.1136/adc.2003.044743. PMID: 14977713; PMCID: PMC1719845.
• 37. Basaran S, Ögün MR. Clinical and Demographic Profile of Patients with Active Epilepsy: Experience From a Tertiary Care Hospital in Turkey. Kocaeli Med J. 2019;8(2):142-49. doi: 10.5505/ktd.2019.59489
• 38. Genç F, Kutlu G, Gömceli YB, İnan LE. Ankara Eğitim ve Araştırma Hastanesi Epilepsi Bölümü’nde Düzenli Takip Edilen Dirençli Epilepsi Hastalarının Demografik ve Klinik Bulguları. Journal of the Turkish Epilepsi Society. 2013;19(2):79-84. doi: 10.5505/epilepsi.2013.68552