Clinical Features and Evaluation in Terms of Prophylaxis of Patients With Febrile Seizures

Objectives: Febrile seizures are the most common seizure type of childhood, and prognosis is usually good. Many factors that increase the risk of recurrence and develop epilepsy have been identified. This study aims to determine the clinical characteristics of patients who were admitted with the febrile seizure, and determine the outcomes of the treatment, and the risk factors.
Methods: Between January 2017 and January 2019, 147 (42.6%) female and 198 (57.4%) male patients who were admitted with febrile seizure, and aged between 3-60 months were included in the study.
Results: The mean age at the time of admission was 30.4±15.4 months, and the mean age of the first seizure was 21.2±12.8 months. Simple febrile seizure was seen in 247 (71.6%) patients, and complex febrile seizure was seen in 89 (25.8%) patients while febrile status epilepticus was present in 9 (2.6%) patients. Amongst the patients, 59.1% of them had a history of repetitive febrile seizure. First-degree relatives of thirty (8.69%) patients had a history of epilepsy, while 176 (51%) patients had a family history of febrile seizure. Two hundred and seventy-five patients (79.7%) found to have an infection, most frequently respiratory tract infection (53.8%), during the examination, which might cause fever. One hundred and ninety-five patients were followed without treatment, while 48.6% of the patients were treated with rectal diazepam, 23.3% with sodium valproate, 23.3% with levetiracetam and 4.6% with phenobarbital. At the end of the one-year follow-up, only four patients (1.15%) with complex febrile seizure were diagnosed with epilepsy. The age of the onset of febrile seizures, family history of febrile seizures, short episodes of febrile seizure and the presence of epilepsy in the family history were found to be the significant risk factors for repetitive seizures.
Conclusion: Febrile seizures are generally benign and have a low risk of developing epilepsy. Determining the risk factors is essential for the treatment and follow-up plan.

Febril Nöbeti Olan Vakalarýn Klinik Özellikleri ve Proflaksi Açýsýndan Deðerlendirilmesi

Amaç: Febril nöbetler, çocukluk çaðýnda en sýk görülen nöbet türüdür. Çoðu çocukta prognoz iyidir. Nöbet tekrarý ve epilepsi geliþim riskini artýran birçok faktör tanýmlanmýþtýr. Bu çalýþmanýn amacý febril nöbet nedeniyle baþvuran hasta¬larýn klinik özellikleri, aldýklarý tedavi ve izlem sonuçlarýný araþtýrmak ve risk faktörlerini belirlemektir.
Yöntem: Mart 2017 ile Aralýk 2018 tarihleri arasýnda febril nöbet nedeniyle yönlendirilen yaþlarý 3-60 ay arasýnda olan 147’si (%42,6) kýz, 198’i (%57,4) erkek olan toplam 345 hasta dahil edildi.
Bulgular: Baþvuru sýrasýnda ortalama yaþ 30,4±15,4 ay, ilk nöbet geçirme yaþý ise ortalama 21,2±12,8 aydý. Basit febril nöbet 247 (%71,6), komplike febril nöbet 89 (%25,8), febril status epileptikus 9 (%2,6) hastada saptandý. Hastalarýn %59,1’inde tek¬rarlayan febril nöbet öyküsü vardý. Otuz (%8,69) has¬tanýn birinci derece akrabalarýnda epilepsi öyküsü, 176 (%51) hastanýn ailesinde ise febril nöbet öyküsü vardý. En sýk üst solunum yolu enfeksiyonu (%53,8) olmak üzere iki yüz yetmiþbeþ ( %79,7) hastada muayene esnasýnda ateþe neden olabilecek enfeksiyon tespit edildi. Yüz doksanbeþ hasta tedavisiz izlenirken, tedavi verilen hastalarýn %48,6’sýna rektal diazepam, %23,3’üne sodyum valproat, %23,3’üne levetirasetam, %4,6’sýna fenobarbital baþlandý. Bir yýllýk izlem sonunda sadece komplike febril nöbeti olan 4 hasta (% 1,15) epilepsi tanýsý aldý. Febril nöbetin baþlangýç yaþý, ailede febril nöbet öyküsü, nöbet öncesi ateþli dönemin kýsa olmasý ve ailede epilepsi varlýðý nöbetlerin tekrarý açýsýndan anlamlý risk faktörleri olarak bulundu.
Sonuç: Febril nöbetler genel olarak iyi huylu nöbetler olup epilepsi geliþim riski düþüktür. Risk faktörlerini belirlemek tedavi ve takip planý için önemlidir.