aspects regarding the etiology and clinical matters of the febrile seizures in children first...

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ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana Craciun, Diana Lapusneanu, Maria Magdalena Aloje Coordinator: Asist. Univ. Dr. Alina Grama

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Page 1: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN  

First Author: Iulia Laura GavrilaAuthor: Alina Grama, Adriana Craciun, Diana Lapusneanu, Maria Magdalena AlojeCoordinator: Asist. Univ. Dr. Alina Grama

Page 2: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

INTRODUCTION

Febrile seizures are the most common seizure disorder in childhood. They are a benign epileptic manifestation of infancy occurring between 6 months and 5 years of age, accompanied by fever and affecting an estimated 2-5 % of children with no neurological history.

Page 3: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

Purpose: Was the evaluation of febrile seizures on children hospitalized in Pediatric 1 Clinic of Targu Mures.

Material and method: A retrospective study was performed on 195 patients diagnosed with Febrile Seizures, between January 2009- December 2012.

Page 4: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

RESULTS OBTAINED AFTER GROUPING FS BY SEX AND ENVIRONMENTAL ORIGIN

Male

Female

114

81

Rural environment

Urban environment

103

92

Number Number

Page 5: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

Results obtained from the clustering of cases by age

Age of patients Minim Average Maxim

Age group < 6 months6 months to

5 years> 5 years

Percentage in the number of

cases5,1 % 91,3 % 3,6 %

Page 6: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

THE NUMBER OF PATIENTS WITH SIMPLE/COMPLEX FS BY AGE

Simple FS Complex FS0

20

40

60

80

100

120

140

4 6

133

46

3 4

< 6 months

6 months - 5 years

> 5 years

Simple FS = generalized seizures, lasting less than 15 minutes, and without recurrence within 24 hours

Complex FS = have focal semiology, last more than 15 min and have more than one episode during the same febrile event

Page 7: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

THE DISTRIBUTION OF CASES IN EACH OF THE 4 YEARS (INCLUDED IN THIS STUDY)

Series1

0.00%5.00%

10.00%15.00%20.00%25.00%30.00%35.00%

2009

2010

2011

2012

19.50%

20.50%

25.10%

34,9

2009201020112012

Page 8: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

TYPE OF SEIZURE FREQUENCY ACCORDING TO

GENDER

Simple FS Complex FS0

20

40

60

80

100

120

140

Female

Male

Total58

23

82

32

140

55

Page 9: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

TYPE OF MANIFESTATIONS

Tonic-clonic seizures

Tonic seizures

Atonic seizures

Clonic seizures

0.00% 20.00% 40.00% 60.00%

56.40%

20.50%

12.30%

8.20%

Page 10: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

FREQUENCY OF DISEASES RELATED TO FEBRILE SEIZURES

Series10%

10%

20%

30%

40%

50%

60%

70%

80% 80%

24.10%

8.20%9.70%3.60%2.60%

Superior Airway in-fectionsInferior Airway in-fectionsUrinary infectionsEruptive diseases Vaccination reac-tionAcute enterocolitis

Page 11: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

ETIOLOGY RESULTING FROM THE STUDY

Bacterial infection Viral infection0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

120.00%

97.40%

2.60%

Page 12: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

BACTERIAL INFECTION/TYPE OF SEIZURES/SEASONS

Complex FS Simple

FS Total FS - bact inf Total FS

- viral inf

0

10

20

30

40

50

60

70

20

41

61

0

10

3646

2

720 27

2

16

40

56

1

SpringSummerAutumnWinter

Page 13: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

Results: Family history of seizures and epilepsy

 Frequency (number)

Percent

Seizures 11 5,6

No Seizures 184 94,4

Epilepsy 13 6,7

No Epilepsy 182 93,3

Page 14: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

THE RISK OF RECURRENT FS / AGE <1 YEAR OF THE FIRST FS

020406080

100120140160180200

2228

50

27

118

145

49

146

195

recurrent FSnon-re-current FSTotal

 p=0,01Value

95% Confidence Interval

Lower Upper

Odds Ratio for Age of 1st FS< 1 year (da / nu)

3,434 1,709 6,898

For cohort Recurrent FS = yes

2,341 1,485 3,690

For cohort Recurent = no

,682 ,523 ,888

N of Valid Cases

195   

Page 15: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

CONCLUSIONS As in the literature, this study proves that simple febrile seizures, with tonic-clonic manifestations are most frequently seen especially in male children between 6 months and 5 years old.

In addition to this, I have determined that: The risk of recurrent FS is 3,4 times higher for patients where 1st F.S. occurred at the age of under 1 year compared to those where it occurred at an age of more than 1 year. The number of cases is higher in the rural environment In the 4 study years, the number of cases increased The bacterial etiology is predominant Superior airway infections were frequently associated with F.S Both simple and complex FS appeared more often in spring

and winter.

Page 16: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

BIBLIOGRAPHY http://www.ncbi.nlm.nih.gov/pubmed/24477659# http://www.medscape.com/viewarticle/769023 http://www.ncbi.nlm.nih.gov/pubmed/7594268 Togănel R.: Puericultură, Litografia UMF, Târgu-Mureș, 2009 Baghiu M.D: Lecţiuni de pediatrie, Târgu-Mureş, 2009, vol. II Baumann RJ. Technical report: treatment of the child with simple febrile

seizure. Pediatrics 1999;103:e86.www.pediatrics.org/cgi/content/full/ 103/6/e86 (accessed 19 June

Butnariu A., Badiu I., Boros E. : Puericultura şi Pediatrie, Ed. 4, Editura Medicala Universitara Iuliu Hateganu, Cluj Napoca, 2011

Bui T, Delgado C, Simon H – Infant seizures not so infantile: first-time seizures în children under six months of age presenting to the ED. Am J Emerg Med, 2002

Friedman MJ, Sharieff GQ – Seizures în children. Pediatr Clin N Am, 2006 Man C. Sorin, Manulescu V. Mircea: Pediatrie Pediatrica, Editura

Risoprint Cluj Napoca, 2006 Popescu V – Convulsiile febrile. Revista Română de Pediatrie, 2006, LV

Page 17: ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN First Author: Iulia Laura Gavrila Author: Alina Grama, Adriana

THANK YOU!