The assessment of risk factors and sociodemographic characteristics of the children, apply pediatric emergency unit with febrile convulsion complaint and hospitalized in our clinic

The assessment of risk factors and sociodemographic characteristics of the children, apply Pediatric Emergency Unit with febrile convulsion complaint and hospitalized in our clinic. Objectives: Febrile convulsions (FK) are the most common type of convulsions seen in children and are the top ranks among childhood neurological disorders. It is seen that the febrile seizure, which is considered to be a good course, is frequently seen in the community and it is important to follow the cause of the seizure with high possibility of recurrence. The aim of this study was to determine the clinical, laboratory and sociodemographic characteristics of patients hospitalized with febrile convulsion diagnosis between 6 months and 6 years of age and to determine the risk of recurrence and epilepsy and to evaluate the efficacy of different treatment alternatives in follow-up Materials and methods: Total of 159 patients ages ranged from 6 months to 6 years who apply to Emergency Unit of Child Health and Diseases of Adıyaman University Faculty of Medicine Education and Research Hospital with febril convulsion complaint and hospitalized with Febril Convulsions diagnosis, between 01.9.2015- 31.08.2016 were enrolled. All patients had sociodemographic data and risk factors as well as clinical features, serum glucose, sodium, potassium, chlorine, calcium level, leukocyte count, hemoglobin, complete urine test, CRP value of 152 patients, electroencephalography result of 44 patients, computerized brain imaging laboratory parameters such as tomography (CT) and brain MRI (magnetic resonance imaging) of 18 patients were recorded. Data were analyzed using the SPSS (Statistical Package For Social Sciences) 23.0 program (SPSS Inc., Chicago, IL, United States). Results: In our study mean age of children was 23,9±16,5 months and the ratio of boys/girls are 1,12/1. The most common incident of fever was the upper respiratory tract infection (55,3 %). The first febril seizure was before 2 years old (79,9 %). In children with febrile seizure, there was 8,2 % family history of febrile seizure and 20 % intermarriage between parents. In children with febrile seizure, the mean rectal body temperature was found 38,3± 0,64 °C. From the total cases of the children with febrile seizure, 142 had simple febrile seizure, and 17 had complex febrile seizure. Biochemical studies of the cases; glucose, electrolytes, urea creatinine, alanine amino transferase (ALT) and aspartate aminotransferase (AST) values were normal in all patients. CRP was positive in 62 out of 152 cases (40.7 %) who had CRP. In 87.4% of the cases, seizures were seen in the form of generalized tonic clonic (JTC). FK recurrence was present in 80 of the patients (50.3 %), and 2 times in 1 of 74 (92.5), 5 (6,25 %) and 3 times in 1 recurrence. Of the recurrence cases, 48,7% were male and 51,3 % were female. In the 80 children with recurrent febrile seizures, 12 (15 %) children had family history. In the children with complex febrile seizures, the febrile seizure recurrence rate was 58,8 % . Electroencephalography (EEG) was found in 44 of all these cases and 11 of them (25%) were found to have abnormal EEG. There was high prevalance of abnormal EEG in the children with complex febrile seizures than in the children with simple febrile seizures. In our study, there was epilepsy in 8 (5 %) children. The rate of epilepsy was 2,8 % in the children with simple febrile seizures since it was 23,5 % in the children with complex febrile seizures. EEG anomalies were present in 3 (37,5 %) of 8 patients with epilepsy. Epilepsy was found in 20 % of those who had epilepsy stories in their family, and in 3 (60 %) of 5 patients who had an epileptic attack three times. The recurrence rate of febrile seizures was high in the children with family history of febrile seizures and with abnormal EEG. In our study, the recurrence rate was 51,3 % in the group given midazolam (iv), 50,3 % in the antipyretic group, 50 % in the phenobarbital group and 48,7 % in the phenytoin group whereas there was a statistically significant difference between treatment and recurrence development no relationship was found. Conclusion: Febrile seizures, known as good prognosis, has high recurrence rates and has high risks of epilepsy than normal population so it is important to follow up febrile seizures. In preventing recurrences, although we could not find any difference among different treatment strategies In terms of fever causing febrile seizures, the children with high risk should be choosen wisely, to train the families for reducing body temperature fever and using rectal diazepam and warn them to take health care in an health center in time when needed. The main goal of the management is to discontinue the acute episodes, to prevent the recurrence, to lower the risk of epilepsy and to instruct the families to reduce the phobia of fever. Key words: Childhood, epilepsy, febrile convulsion, fever, recurrency, risk