Family History Of Convulsions Research Articles

A study of febrile convulsions with a bacteremia incidence in a tertiary care teaching hospital in Andhra Pradesh

Background: A febrile convulsion is linked with high temperature but without significant underlying health issues. These occur most often in children aged six months to five years. Most of the convulsions last less than five minutes, and within an hour of the occurrence, the child is entirely back to normal.Methods: Sixty children aged 3 months to 5 years admitted to the emergency pediatric ward with a history of convulsion fever with convulsions, in Narayana Medical College and Hospital were taken up for the study with clinical history, clinical examination, laboratory Investigations.Results: Among 60 children in the study group, 15 (25%) of them were aged between 3 months to 12 months, 21 (35%) of them were between 13 months to 24 months. Gender 36 (60%) are male children. 24 (40%) are female children. Family history of convulsions was positive in 18 (30%) of the 60 (100%) cases, and 7 had family history of epilepsy. 42 (70%) are negative. Most of the cases (85%) showed no growth in blood culture.Conclusions: Blood culture should be performed in all children by febrile convulsions, especially those under the stage of two years. Streptococcus pneumonia was the organism isolated from respiratory tract infection in a child with febrile convulsion with significant bacteremia. The symptoms that present can be as harmless as rhinorrhea or cough. Children with a positive family history of afebrile convulsion should be closely monitored and test, as they can develop epilepsy later.

Relationship of Family History of Convulsions to the Febrile Seizures

Febrile fits are the commonest cause of seizures in children less than 5 years of age. There are two categories of febrile seizures-simple and complex. The present study was conducted in Tirunelveli to know the relationship of family history of convulsions to the type of febrile convulsions. 30% of children showed family history of febrile convulsions. Simple febrile seizures are most common in children with positive family history of convulsions.

Identification of risk factors for recurrent febrile convulsion

Background Febrile convulsion (FC) occurs in about 2 to 4percent of all children, approximately one third of whom willthen develop recurrent febrile convulsion (RFC). Risk factorsfor RFC are family history of convulsions, an age of less than 18months, a relatively lower temperature and shorter duration offever preceeding the first FC.Objective The aim of the study was to determine the risk factorsfor RFC.Methods One hundred children aged 6 months to 5 years withFC or RFC were included in this case-controlled study, which wascarried out from July 2006 to June 2007. Data on the children'sfirst FC were collected from medical records and the family historywas taken directly from the parents.Results Fifty children with RFC and 50 children withoutrecurrence were included in this study. An age of less than 18months (P< 0.0001, COR= 71.37), a family history of FC(P< 0.0001, COR= 6.00), and a fever duration ofless than 12hours preceding the first FC (P< 0.0001, COR = 4.96) wereassociated with a risk of recurrence. A relatively lower degree oftemperature at first febrile convulsion did not increase the riskfor RFC (P = 1.21). Multivariate logistic regression showed thatyounger age and shorter duration of fever preceding the first FCwere associated with RFC.Conclusion Younger age and shorter duration of fever precedingthe first FC are associated with an increased risk ofRFC.

Photosensitive fits elicited by TV animation: an electroencephalographic study.

We carried out a clinical and electroencephalographic (EEG) study to reveal the pathophysiology of acute symptoms elicited by a TV animation program. Clinical data and EEG were obtained from 20 patients ranging in age from 6 to 30 years. A pattern presentation and an intermittent photic stimulation were performed. Of 20 patients, 13 had a convulsion and seven had other symptoms, mainly nausea and/or vomiting. A photoparoxysmal response (PPR) was confirmed in 12 of 13 patients (92.3%) who had a convulsion. Only one of seven patients (14.3%) without a convulsion showed a PPR. The incidence of PPR was significantly higher in patients with convulsion than those without convulsion. There were no significant differences in the family history of convulsion, gender, parameters associated with TV watching and basic EEG between the two groups. All patients with PPR had a convulsion or consciousness disturbance. Acute symptoms, such as convulsion and impairment of consciousness, are supposed to be based on photosensitivity.

Iron deficiency anaemia and febrile convulsions: case-control study in children under 2 years.

Febrile convulsions are the most common type of seizure and occur in 2-4% of all children.1 A family history of convulsions; maternal smoking; and alcohol consumption during pregnancy have been associated with febrile seizures,2 3 but the risk factors remain largely unknown. Iron is involved in the metabolism of several neurotransmitters, and monoamine and aldehyde oxidase are reduced in iron deficiency anaemia4, which is common during the second and the third year of life and has been associated with behavioural and development disturbances.5 Thus we investigated the association between iron deficiency anaemia and febrile seizures by a case-control study. All 156 children …

Predictors of Neonatal Encephalopathy in Full Term Infants

Abstract Objective : Preliminary investigation of the contribution of adverse antepartum and intrapartum factors to neonatal encephalopathy in singleton neonates born full term. Design : Matched case-control study based on incidence density sampling of controls. Setting : Two major teaching hospitals (one paediatric and one obstetric) and three peripheral maternity hospitals in Perth, Western Australia (population 1.2 million). Subjects : 89 cases, all the full term singleton neonates born during an eight month period in 1992 who fulfilled one or more of six criteria during the first week of life (seizures, abnormal conscious state, persistent hypertonia or hypotonia, and feeding or respiratory difficulties of central origin). One full term control infant without neonatal encephalopathy was matched to each case by sex, hospital of delivery, time of day and day of the week of birth, and maternal health insurance status. Main outcome measures : Odds ratio estimates of relative risk of neonatal encephalopathy associated with antepartum and intrapartum factors. Results : Estimated incidence of moderate or severe encephalopathy in first week of life was 3.75 per 1000 full term live births. Thirteen cases and no controls had evidence suggestive of important intrapartum hypoxia, and in only five of these cases was the neurological condition at birth attributed to events during the intrapartum period. Univariate conditional logistic regression analysis identified significant differences between cases and controls for maternal vaginal bleeding in pregnancy, maternal thyroxine treatment, congenital abnormalities, induction of labour, interval from membrane rupture to delivery, maternal pyrexia in labour, augmentation of labour, abnormal intrapartum cardiotocograms, and meconium in labour. Family history of convulsions also approached significance. Conclusions : Our preliminary results suggest that intrapartum hypoxia, according to currently used criteria, was not the cause of neonatal encephalopathy in most cases in this population. Our findings suggest that many aetiologies of neonatal encephalopathy originate in the antepartum period.

Predictors of neonatal encephalopathy in full term infants

Preliminary investigation of the contribution of adverse antepartum and intrapartum factors to neonatal encephalopathy in singleton neonates born full term. Matched case-control study based on incidence density sampling of controls. Two major teaching hospitals (one paediatric and one obstetric) and three peripheral maternity hospitals in Perth, Western Australia (population 1.2 million). 89 cases, all the full term singleton neonates born during an eight month period in 1992 who fulfilled one or more of six criteria during the first week of life (seizures, abnormal conscious state, persistent hypertonia or hypotonia, and feeding or respiratory difficulties of central origin). One full term control infant without neonatal encephalopathy was matched to each case by sex, hospital of delivery, time of day and day of the week of birth, and maternal health insurance status. Odds ratio estimates of relative risk of neonatal encephalopathy associated with antepartum and intrapartum factors. Estimated incidence of moderate or severe encephalopathy in first week of life was 3.75 per 1000 full term live births. Thirteen cases and no controls had evidence suggestive of important intrapartum hypoxia, and in only five of these cases was the neurological condition at birth attributed to events during the intrapartum period. Univariate conditional logistic regression analysis identified significant differences between cases and controls for maternal vaginal bleeding in pregnancy, maternal thyroxine treatment, congenital abnormalities, induction of labour, interval from membrane rupture to delivery, maternal pyrexia in labour, augmentation of labour, abnormal intrapartum cardiotocograms, and meconium in labour. Family history of convulsions also approached significance. Our preliminary results suggest that intrapartum hypoxia, according to currently used criteria, was not the cause of neonatal encephalopathy in most cases in this population. Our findings suggest that many aetiologies of neonatal encephalopathy originate in the antepartum period.

Exfoliative Dermatitis (Sodium Valproate Induced)

Letters to the EditorExfoliative Dermatitis (Sodium Valproate Induced) Ghulam NabiMD Ghulam Nabi Chief Pediatrician, Civil Hospital, P.O. Box 737, Khamis Mushyat, Saudi Arabia Search for more papers by this author Published Online:1 Jul 1993https://doi.org/10.5144/0256-4947.1993.388SectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionTo the Editor: Exfoliative dermatitis is an erythematous scaling eruption which involves most or all of the skin. The eruption can vary from slight scaling and minimal redness to generalized desquamation associated with systemic toxic symptoms [1]. Sodium valproate is being used for febrile convulsions with no particular toxic effect in young children [2]. We are reporting a case of recurrent febrile convulsions who was put on long term anticonvulsive therapy, sodium valproate, and developed one of the rare complications, exfoliative dermatitis, with this drug.A two-year-old Sudanese male presented with a history of recurrent convulsions since the age of nine months. He had five attacks of convulsions until he reported to our clinic. Each attack lasted from three to five minutes, tonic clonic type, always associated with respiratory tract infection and fever. The patient was getting the treatment for each episode from the local dispensary, syrup ampicillin and paracetamol. Antenatal, natal, and postnatal history were uneventful. There was no family history of convulsions or skin disease. On examination, the patient was of average build and undernourished; growth parameters were a weight of 10 kg (below the tenth percentile), length 85 cm and head circumference 48 cm, both normal. Vital signs were within normal limits. There was no neurological deficit and all other systems were clinically normal. Investigations: hemoglobin, total leucocyte count, total proteins, serum electrolytes, blood glucose, blood gases, x-ray of the skull, electroencephalography, and liver function tests were all normal. The patient was put on long term anticonvulsive therapy of Depakine syrup (sodium valproate) 20 mg/kg/day in two divided doses per oral for a period of two years.Six weeks after starting the treatment, he developed generalized redness of the skin with itching all over the body. The erythema was a bright red, classical allergic drug rash. The patient was taking only Depakine and no other medication. There was no fever, jaundice, lymphadenopathy, hepatosplenomegaly, or signs of congestive cardiac failure. The drug was stopped and the patient was put on chlorpheniramine maleate syrup 0.35 mg/kg/day in three divided doses per oral. Local application of calamine lotion was used as a soothing agent. Itching subsided and desquamation started; this lasted for a period of two weeks. In a total period of one month, skin was normal and the child was healthy. He is coming for follow-up regularly.Sodium valproate is a widely used drug for febrile convulsions. Usually in therapeutic doses, there are minimal side effects [2]. One of the rare complications of this drug is hepatotoxicity (one per 10,000 patients) [3]. Idiosyncrasy has been reported in some cases but exfoliative dermatitis due to this drug is very rare [4]. Exfoliative dermatitis is more common in adults than in children and males are affected more than females [5]. The patient developed skin rash and itching six weeks after starting the treatment. He was taking only this medication and there was no associated disease, so we presumed this was a delayed allergic drug reaction. After the drug was stopped, the patient was put on oral antihistamine and local application of calamine lotion. The itching stopped and desquamation started, which lasted for two weeks. In a total period of one month, the skin was normal. Our patient was undernourished and susceptibility to the infection in these cases is well known. Correlation between undernutrition and drug allergy is not known. Exfoliative dermatitis is associated with fever, lymphadenopathy, heart failure, dehydration, splenomegaly, bacterial infection, and partial or complete alopecia; none of these were present in our patient [5]. In conclusion, sodium valproate is being used widely for convulsive disorders. Besides known adverse side effects, there may be involvement of skin in the form of exfoliative dermatitis. Physicians who care for children who are on sodium valproate therapy should bear this complication in mind.ARTICLE REFERENCES:1. Thomas RM. "Drug eruptions" . Med Int’l, Middle Eastern Edition, Derm. 1992; 1(2):4273-7. Google Scholar2. Monaco F, Mele G, Meloni T, et al.. "A longitudinal study of valproate free fraction in the specific age group at greatest risk for febrile convulsions (children below three years)" . Epilepsia, 1984; 25(2):240-3. Google Scholar3. Murphy JV. "Valproate monotherapy in children" . Am J Med. 1988; 84(1A):17-22. Google Scholar4. Sharma M, Agrawal P. "Valproic acid" . Ind Pediatr. 1991; 28:921-4. Google Scholar5. Nicolis GD, Helwig EB. "Exfoliative dermatitis" . Arch Derm. 1973; 108:788-97. Google Scholar Previous article FiguresReferencesRelatedDetails Volume 13, Issue 4July 1993 Metrics History Published online1 July 1993 InformationCopyright © 1993, Annals of Saudi MedicinePDF download

Family History of Convulsions in Candidates for Immunization With Pertussis-Containing Vaccines (Diphtheria, Tetanus, Pertussis)

Family history of convulsions is not presently a contraindication to the use of pertussis vaccine.1,2 It was suggested in a recent report that there might be an increased risk of seizures following diphtheria, tetanus, pertussis (DTP) vaccination in individuals who have a "family history of convulsions." Unfortunately, the degree of relatedness was not specified in the questionnaire from which these results were derived.3 A subsequent questionnaire specifying relatedness only to siblings and parents also indicated an increased risk. A family history of convulsions was obtained in 17.3% and 16.7% of children who had febrile and nonfebrile convulsions, respectively, following DTP vaccine as compared with 4.8% in vaccinees who had nonneurologic complications following DTP vaccination (Centers for Disease Control, unpublished data, 1987). The risk of seizures following DTP vaccination is approximately one in 1,750 doses. These are usually febrile seizures.4,5 Follow-up of these patients had indicated that they rarely, if ever, have sequelae.5 Convulsions of this type (DTP vaccination induced) are differentiated from encephalopathy which occurs once in about 1:140,000 doses, one third of which result in permanent sequelae.6 Recent studies have demonstrated that the administration of acetaminophen, 15 mg/kg per dose, at the time of immunization with DTP and four and eight hours later, reduces febrile reactions.7 Although this study was too small to allow determination of the effect on seizures following DTP, it is reasonable to expect that reduction in fever also would decrease the likelihood of febrile seizures following DTP. Local pertussis epidemics in the United States occur in unpredictable fashion.

DPT for children with family history of convulsions

DPT for children with family history of convulsions

Leads from the MMWR. Pertussis immunization; family history of convulsions and use of antipyretics--supplementary ACIP statement

Leads from the MMWR. Pertussis immunization; family history of convulsions and use of antipyretics--supplementary ACIP statement

History of convulsions and use of pertussis vaccine

Data on 2062 reports from the Monitoring System for Adverse Events Following Immunization, Centers for Disease Control (CDC), were analyzed to compare the risk of a personal or family history of convulsions in children who had a neurologic adverse event after receipt of diphtheria-tetanus-pertussis (DTP) vaccine with those who had a nonneurologic adverse event. Children with a neurologic event after DTP vaccine had a 7.2 times higher risk for personal history of convulsions (95% confidence limits 4.5 to 11.5) and a 4.5 times higher risk for family history of convulsions (95% confidence limits 3.1 to 6.7) than did children with an adverse event that did not affect the nervous system. Children with either a febrile or nonfebrile convulsion after receipt of DTP were significantly more likely to have a personal history of convulsions than children with a nonneurologic adverse event (P less than 0.0001). Children with a febrile convulsion after receipt of DTP but not children with nonfebrile convulsions were significantly more likely to have a family history of convulsions than those with a nonneurologic adverse event. It is recommended that pertussis vaccination be deferred in children with a personal history of a convulsion until it can be determined that an evolving neurologic disorder is not present. If such disorders are found, these children should be given the combined pediatric diphtheria and tetanus toxoids (DT) vaccine to complete the series.

Convulsions in shigellosis. Evaluation of possible risk factors.

We studied 158 children with culture-proven shigellosis, 37 (23.4%) of whom had convulsions. Historical, clinical, and laboratory data were compared between patients with and without convulsions to define risk factors for the development of seizures. Age was the most important predisposing factor. The highest incidence of shigellosis associated with convulsions was found in children between 6 months and 4 years of age. Peak body temperature and a family history of convulsions also independently affected the development of seizures. Sex and Shigella strain showed differences between the groups but failed to reach statistical significance.

Convulsions following birth asphyxia/birth trauma--are long-term anticonvulsants necessary?

. A retrospective study of case notes was undertaken at the Royal Children's Hospital Melbourne, over a five-year period 1974–1978 inclusive, to determine the need for long term anticonvulsant medication for infants who had convulsions in the neonatal period following birth asphyxia and/or trauma. Anticonvulsants were generally ceased before discharge from hospital. Of 38 infants available for follow up, 30 had no recurrence of convulsions by 12 months of age. Of the remaining 8 infants, one had a febrile convulsion, one infant remained on treatment because of a family history of convulsions and later convulsed with fever, one infant who convulsed at six weeks of age and five infants with major neurological sequelae who convulsed beyond the neonatal period, were recommenced on anticonvulsants. Twenty seven of the 38 infants were developmentally normal, and 11/30 had major neurological sequelae (five of these 11 had subsequent convulsions). If an infant ceases convulsing, and is behaving normally at discharge, long term anticonvulsants are not necessary.

Psychomotor seizures in childhood: A clinical study of 120 cases

Summary One hundred and twenty cases of psychomotor epilepsy in children have been reviewed. 1. Eleven per cent of 1,054 pediatric patients with epilepsy had psychomotor attacks. In our experience psychomotor epilepsy is twice as common as the petit mal type. 2. Clinically, the cases could be divided broadly into 5 types of behavior: arrest of activity, masticatory, automatic, psychic, and vertiginous. 3. Fifty-five children had a family history of convulsions; parents or siblings were affected in 23. 4. Thirty per cent had an age at onset of 3 years or less. This is half the percentage of that seen in 1,054 cases of all types of epilepsy in childhood. 5. One third of the children had an obvious background of organicity. The etiological significance of previous convulsions, particularly febrile seizures, is emphasized. 6. The majority of cases were misdiagnosed as petit mal seizures. Hysteria, behavior disorder, nightmares, and fabrication must also be ruled out. 7. One fourth of those in the series were mentally deficient children as determined of those in the tested group exhibited behavior disorders. 8. Of 117 electroencephalograms, only 17 were normal or indeterminate. 9. About one third of the patients with psychomotor epilepsy were completely controlled, another third were not controlled, and one third were inadequately followed for proper evaluation. Acetazolamide as an adjuvant to previous therapy is recommended in intractable cases.

The EEG effect of metrazol and photic stimulation in 682 normal subjects

1. 1. Six hundred and eighty-two normal air force applicants, ages 17–24, were examined electroencephalographically at rest and during provocation with hyperventilation, photic stimulation and Metrazol. Electroencephalograms were classified as normal (84.9 per cent); borderline (5.1 per cent); slightly abnormal, non-paroxysmal (3.8 per cent); markedly abnormal, non-paroxysmal (2.6 per cent); questionably paroxysmal (0.9 per cent); and paroxysmal (2.6 per cent). 2. 2. Clinical information included personal history of head injury (11), birth injury (2), fainting (2), and meningitis (1); family history of convulsions (10), and questionable (12) or definite neurological (36) findings. Seventy-seven subjects had one or a combination of these findings suggesting neurological involvement. 3. 3. The incidence of Metrazol-induced paroxysms was correlated both with the appearance of the EEG at rest, and with the neurological status as indicated by the personal and family history and neurological findings. 4. 4. Metrazol-induced paroxysms occurred in 15 per cent of subjects with a normal EEG; 32 per cent of those with a borderline; 40 per cent of those with a slightly, non-paroxysmally abnormal; 47 per cent of those with a questionably paroxysmal; 50 per cent of those with a paroxysmal pre-Metrazol EEG; and in 27 per cent of those with a markedly but non-paroxysmally abnormal EEG. 5. 5. The “neurologically involved” subjects had eight times the incidence of paroxysmal abnormalities and about two times the incidence of other abnormalities as in the non-involved group. Fifty-three per cent of the “neurologically involved” subjects developed Metrazol-induced paroxysms as compared with 15 per cent of subjects with no such evidence. Neurologically involved subjects with a normal pre-Metrazol EEG had a high incidence (51 per cent) of Metrazol-induced paroxysms. 6. 6. Of the 682 applicants, 30 per cent were rejected, and of these, 16.3 per cent had paroxysmal or markedly abnormal EEGs at rest and with hyperventilation and photic stimulation, and 30.2 per cent Metrazol-induced paroxysms. Twenty-five per cent were dismissed after admission, and of these, 9.6 per cent had paroxysmal or markedly abnormal EEGs, and 16.9 per cent Metrazol-induced paroxysms. Of the 46 per cent who completed training successfully, 8.7 per cent had paroxysmal or markedly abnormal, and 14.2 per cent Metrazol-induced paroxysms. 7. 7. Compared with 682 normals, with an 82.3 per cent incidence of normal EEGs and a 2.9 per cent incidence of paroxysmal EEGs, 100 patients with grand mal epilepsy had a 37 per cent incidence of normal or borderline EEGs and a 36 per cent of paroxysmal abnormalities. Of subjects in both groups with a normal EEG, 15 per cent of normals and 80 per cent of grand mal epileptics developed paroxysms with Metrazol. Corresponding figures for the effect of photic stimulation, indicate that 1.4 per cent of normals and 15 per cent of epileptics develop paroxysmal abnormalities with photic stimulation. An estimate is given for the diagnostic efficacy of Metrazol and photic stimulation in cases of grand mal epilepsy with a normal EEG. 8. 8. Metrazol provocation in this normal group thus confirms the diagnostic value of this method in epilepsy, and also confirms the validity of the usual interpretation of EEG abnormalities in non-epileptic subjects as probably representing acquired or inherent lowered convulsive threshold; and it suggests similarly the presence of such factors in individuals with a normal EEG who develop Metrazol-induced convulsions.