Febrile Convulsions After The Age of Five Years

OBJECTIVE: ln this study we have perfromed clinical and electroencephalographic investigations on children who had febrile convulsions after the age of five years cmd determined the possibilitiy of epilepsy development.
STUDY DESIGN: Children who had been followed by the Neurology Clinic of Hospital and who had at least febrile afier the age of five years were included in the study. in all patients the following were gathered from the parents: date of birth, psycho-motor development, past-history and family history, onset, frequency and duration of febrile convulsions, type of seizure and fever before febriler convulsion. The patients were examined twice a year and had at least one electroencephalographic (EEG) investigation.
RESULTS: Of the 16 patients 13 were male and 3 were female. In 5 patients the first febrile convulsion was observed after the age of five years and in the rest between 6 moths and 4 years. The follow-up period was between 2 to 5 years. In three patients the repeated EEG investigations were normal, whereas in others there were milf generalized disorganization, generalized spike-wave paroxysms and focal sharp-wave activity.
CONCLUSION: It was concluded that children with febrile convulsions after 5 years of age should be followed carefully for the possibility of developing idiopathic generalized epilepsy particulary if they have abnormal EEG findings.

Beþ Yaþ Sonrasý Görülen Febril Konvülsiyonlar

AMAÇ: Bu çalýþmada 5 yaþýndan sonra febril konvülsiyon (FK) geçiren çocuklarýn klinik ve elektroansefalografik açýsýndan araþtýrýlmasý amaçlanmýþtýr.
MATERYAL-METOD: 1990-1995 yýllarý arasýnda Þiþli Etfal Hastanesi Möroloji Kliniði Epilepsi Polikiniðinde izlenen, 5 yaþýndan sonra bir veya birden fazla FK geçiren 16 hasta çalýþmaya alýnmýþtýr. Hastalarýn tümünde doðum tarihi, doðum ve motor-mental geliþim öyküsü, özgeçmiþ ve soygeçmiþ özellikleri, FK’larýn baþlangýç yaþý, sýklýðý, süresi,nöbet þekli, nöbetten önce ölçülen ateþ anne ve babalardan ayrýntýlý olarak öðrenilmiþtir. Hastalar yolda ortalama iki kez görülmüþ ve en az bir kez elektroansefalografik (EEG) incelemeleri yinelenmiþtir.
BULGULAR: Olgularýmýzýn 3 tanesi kýz, 13 tanesi erkek olarak belirlenmiþtir. Beþ hastada ilk FK 5 yaþýndan sonra, 11 tanesinde ise 6 ay ile 4 yaþ arasýnda görülmüþtür. Nöbetlerin hemen hemen hepsi kýsa süreli jeneralize tonikklonik konvülsiyonlar olarak tarif edilmiþtir. Ýzleme süresi 2-5 yýl arasýnda deðiþmektedir. Hastalarýn 3 tanesinde yinelenen EEG’lere patoloji saptanmamýþ, diðerlerinde ise hafif yaygýn yavaþlama, projete tipte deþarj, jeneralize diken-dalga deþarjlarý ve fokal sivri dalgalar görülmüþtür. Olgularýn hiçbirinde izleme döneminde epilepsi geliþmemiþtir.
SONUÇ: Beþ yaþýndan sonra FK geçiren veya geçirmeye devam eden ve EGG’lerinde anomali saptanan hastalarýn geliþebilecek idiopatik jeneralize epilepsi açýsýndan yakýndan izlenmesi gerektiði sonucuna varýlmýþtýr.