Adecuación de la práctica clínica a la evidencia científica en el tratamiento de las convulsiones febriles

Abstract

An important inconsistency exists between the evidence available about the management of febrile seizures (FC) and its application in real practice. AIM. To value the degree of appropriateness of current management of FC. Structured review of the articles on appropriateness published in biomedical literature. Methodological analysis and qualitative synthesis. The evidence available on the diagnosis and treatment of the FC is little. Except for the related to the preventive treatment of recurrences of FC, the rest of the evaluation criteria is based on the opinion of experts or methods of consensus. Eight articles have been identified that reflect the following problems: insufficient or excessive use of antiepileptic drugs during the seizures, unnecessary accomplishment of lumbar puncture, sanguineous analysis, neuroimage studies or electroencephalograms, and prescription of preventive treatments in simple FC. The methodological quality of the reviewed papers is little and its heterogeneity prevents the quantitative synthesis. The management of FC must be reviewed since an important part of the decisions of the clinical practice is not always sustained in a valid scientific evidence. We only have sufficient evidence on the effectiveness and security of the anticonvulsant treatments to the prevention of the recurrences.