Febrile Seizures and Respiratory Viruses Determined by Multiplex Polymerase Chain Reaction Test and Clinical Diagnosis.

Ji Yoon Han,Seung Beom Han

doi:10.3390/children7110234

Abstract

Febrile seizure (FS) is a common benign seizure disorder of young children. Although upper respiratory tract infection is the cause of fever in most episodes of FS, studies to identify respiratory viruses using a multiplex polymerase chain reaction (mPCR) test have rarely been performed for children with FS. Medical records of children presenting with FS between January 2015 and December 2019 were retrospectively reviewed. Respiratory viruses identified by a rapid influenza detection test and mPCR test were investigated, and their seasonal distribution and the association between viral identification and seizure characteristics were determined. A total of 607 episodes of FS were analyzed: 81.1% of cases were generalized tonic–clonic seizures, 81.5% occurred within 24 h after fever onset, and 87.3% continued for ≤5 min. Complex FS occurred in 17.5% of FS episodes, and epilepsy was diagnosed in 2.5% of tracked cases. Of the 138 mPCR tests performed in 235 hospitalized episodes of FS, 112 (81.2%) tested positive for respiratory viruses: rhinovirus, enterovirus, adenovirus, and influenza virus were most frequently identified. The identified respiratory viruses showed similar seasonal distributions as were observed in community-acquired respiratory tract infections. The identification of a specific respiratory virus was not significantly associated with seizure characteristics or the development of complex FS. In conclusion, respiratory viruses, showing similar seasonal distributions with community-acquired respiratory tract infections and no significant association with the severity and outcomes of FS, should not be rigorously tested for in children with FS.

Highlights

Febrile seizure (FS) is defined as a seizure accompanied by fever, which is not caused by a central nervous system (CNS) infection or metabolic imbalance in children aged between 6 and 60 months and who have no underlying neurologic diseases [1]
We aimed to evaluate the seizure characteristics and cause of fever based on clinical diagnosis and laboratory results in children presenting with FS
After further exclusion of 18 (2.6%) episodes with insufficient records of seizure characteristics, the remaining 607 episodes of FS that occurred in 464 children were eventually included in this study

Summary

Introduction

Febrile seizure (FS) is defined as a seizure accompanied by fever, which is not caused by a central nervous system (CNS) infection or metabolic imbalance in children aged between 6 and 60 months and who have no underlying neurologic diseases [1]. FS affects 2–5% of healthy children, and complex FS, defined as seizure with a duration over 15 min, two or more seizures within 24 h, or focal seizures, is associated with subsequent epilepsy [1]. Genetic epilepsy with febrile seizures plus (GEFS+) is a syndromic autosomal dominant disorder, in which affected family members display various seizure disorders, from simple febrile seizures to more serious phenotypes of epilepsy, and FS may be the initial presentation of GEFS+ [2]. Some mutations of ion channels, such as SCN1A and SCN2A, are known to be associated with GEFS+ [2], and some mutations of ion channels were presumed to be associated with sudden unexpected death in epilepsy and cardiac arrhythmia [3,4].

Objectives

Methods

Results

Conclusion