Incidence Of Febrile Convulsions Research Articles

The Relationship between Iron Deficiency Anemia and the Incidence of Febrile Convulsions

The Relationship between Iron Deficiency Anemia and the Incidence of Febrile Convulsions

Seasonal Trend of Viral Prevalence and Incidence of Febrile Convulsion: A Korea Public Health Data Analysis

Febrile convulsion (FC) is the most common seizure disease in children, which occurs with a fever. We investigated the Korean Health Insurance Review and Assessment Service data of patients aged between 6 months and 5 years at the time of FC diagnosis. Diseases that can cause seizures with fever, such as neoplasms, metabolic disorders, nervous system disorders, cerebrovascular diseases, perinatal problems, and congenital abnormalities, were excluded. Weekly virus-positive detection rate (PDR) data were obtained from the Korea Disease Control and Prevention Agency for adenovirus, parainfluenza virus, respiratory syncytial virus (HRSV), influenza virus, coronavirus (HCoV), rhinovirus (HRV), bocavirus, metapneumovirus (HMPV), rotavirus, norovirus, and astrovirus. Using the Granger test, we then analyzed the monthly PDR and investigated the association between FC incidence and monthly PDR. We additionally identified monthly and seasonal FC incidence trends using the autoregressive integrated moving average. Between 2015 and 2019, 64,291 patients were diagnosed with FC. Annually, the incidence was the highest in May and the lowest in October. Most patients were diagnosed during the spring (26.7%). The PDRs for HRSV, HCoV, HRV, HMPV, and norovirus were associated with FC incidence after 1 month.

Value of Magnetic Resonance Spectroscopy MRS in Prolonged Febrile Convulsion in Children

Abstract Background: Febrile Convulsion (FC) or Febrile Seizure (FS) is the most common type of seizures that occur in children between the ages of 6 months to 5 years with body temperature over 38oC and without any infection such as meningitis and encephalitis in the central nervous system. The incidence of FC is 5 cases per 1000 children annually. Aim of Study: To determine metabolic changes that occur in temporal lobe and hippocampus after prolonged febrile seizures, by using Magnetic Resonance Spectroscopy (MRS). Patients and Methods: Thirty patients with prolonged febrile seizures more than 15 minutes were included. Control group including thirty child age and gender healthy matched. EEG was done within 72 hour of febrile seizure to all case and control group in the study using Pediatric Neurology Department EEG machine. Also, MRS (Magnetic Resonance Spectroscopy) was done within 48h of febrile seizure to the cases and was done to the control group, by using achieva 1.5t Philips. The spectra were all acquired in conjunction with an MRS study of the brain that included coronal T2, axial & coronal FLAIR images through the temporal lobes, and axial T1 and T2 SE images through the entire brain. To obtain MRS technique, scout imaging of the brain in coronal and sagittal orientations was performed with T1 WI. The MRS was per-formed using multi-voxel technique (PRESS-CSI sequence with TE/TR=135ms/1690ms, 12 averages, FOV 120 X 120mm2). The region of interest was placed through whole temporal lobi with the voxel layer position adjusted based on the localization of hippocampi in order to examine the whole hippocampi at long distance (voxel size set to 10 X 10 X 15mm3). The resonances of major metabolites detected were as follows: The N Acetyl Aspartate (NAA) peak at 2.02ppm, the creatine (Cr) and phosphocreatine peak at 3.02ppm, and the choline (Cho) peak at 3.20ppm. Results: We found that there was high significant difference between case and control groups regarding MRS. As in the case group there was reduction of NAA and slightly increase in Cho & Cr, which lead to changes in metabolic ratios (NAA/Cr, Cho/NAA & Cho/Cr). While in the control group was normal.The optimal cut off value of NAA/Cr was less than 2.61, The sensitivity and specificity of NAA/Cr was 96.7% and 93.3% respectively and accuracy was 95%. While, the optimal cut off value of Cho/NAA more than 0.785, the sensitivity and specificity of Cho/NAA was 96.7% and 80% respectively and accuracy was 88.3%. While, the optimal cut off value of Cho/Cr less than 2.115, The sensitivity and specificity of Cho/Cr was 93.3% and 93.3% respectively and accuracy was 93.3%. Conclusion: MR spectroscopy is a very sensitive guiding tool in predicting Temporal Lobe Epilepsy (TLE) and the side of involvement in patients with TLE even in patients with MR negative studies. Also, it helps in detecting abnormal spectra of various brain metabolites at temporal lobe and hippocampus. Further more, it can detect hippocampal injury earlier and with more accurate results than EEG.

Safety profile of the RTS,S/AS01 malaria vaccine in infants and children: additional data from a phase III randomized controlled trial in sub-Saharan Africa

ABSTRACT A phase III, double-blind, randomized, controlled trial (NCT00866619) in sub-Saharan Africa showed RTS,S/AS01 vaccine efficacy against malaria. We now present in-depth safety results from this study. 8922 children (enrolled at 5–17 months) and 6537 infants (enrolled at 6–12 weeks) were 1:1:1-randomized to receive 4 doses of RTS,S/AS01 (R3R) or non-malaria control vaccine (C3C), or 3 RTS,S/AS01 doses plus control (R3C). Aggregate safety data were reviewed by a multi-functional team. Severe malaria with Blantyre Coma Score ≤2 (cerebral malaria [CM]) and gender-specific mortality were assessed post-hoc. Serious adverse event (SAE) and fatal SAE incidences throughout the study were 24.2%–28.4% and 1.5%–2.5%, respectively across groups; 0.0%–0.3% of participants reported vaccination-related SAEs. The incidence of febrile convulsions in children was higher during the first 2–3 days post-vaccination with RTS,S/AS01 than with control vaccine, consistent with the time window of post-vaccination febrile reactions in this study (mostly the day after vaccination). A statistically significant numerical imbalance was observed for meningitis cases in children (R3R: 11, R3C: 10, C3C: 1) but not in infants. CM cases were more frequent in RTS,S/AS01-vaccinated children (R3R: 19, R3C: 24, C3C: 10) but not in infants. All-cause mortality was higher in RTS,S/AS01-vaccinated versus control girls (2.4% vs 1.3%, all ages) in our setting with low overall mortality. The observed meningitis and CM signals are considered likely chance findings, that – given their severity – warrant further evaluation in phase IV studies and WHO-led pilot implementation programs to establish the RTS,S/AS01 benefit-risk profile in real-life settings.

Febrile Seizure Related with Adenovirus Gastroenteritis: A Case Report

Febrile seizure is the most common, age-dependant, benign, and fever-related convulsion of childhood. Its pathogenesis is still not clear. Fever causing febrile seizures is usually associated with viral infections, mostly upper respiratory tract infections, otitis media, tonsillitis, or urinary tract infections. The incidence of febrile convulsions during gastroenteritis is lower and gastroenteritis is thought to exert a protective feature in febril seizures. Although the most common pathogen in gastroeneritis is the rotavirus, adenovirus and small round viruses are also frequently reported. We aim to review the pathogenesis of febrile seizures and discuss vaccination in selected groups with known pathogens while discussing a patient with febrile seizures during adenovirus gastroenteritis. Key Words : Adenovirus Gastroenteritis; Febrile Seizure; Pathogenesis.

Juvenile myoclonic epilepsy: disease expression among Indian families.

Juvenile myoclonic epilepsy (JME) is a common, age related, idiopathic generalized epileptic syndrome. We aimed to define the expression of JME in Indian probands and study the occurrence of seizures/epileptic syndromes in their family members. We studied 225 JME probands with a uniform protocol. recording the type and frequency of seizures, precipitating factors, EEG data, and family history. Detailed family pedigrees were drawn to include all the 1st- and 2nd-degree relatives of probands. The seizures/epileptic syndromes in relatives examined were classified in a uniform way. The clinical and EEG characteristics of 225 JME probands from India were similar to those reported in probands from different ethnic backgrounds. The incidence of febrile convulsions in probands with JME was similar to that of the general population but was much lower (0.2%) among their relatives. A positive family history of seizures among 1st- or 2nd-degree relatives was noted in 79 of 225 (35%) probands. The risk of relatives being affected as well as their risk of expressing a type of idiopathic generalized epilepsy (IGE) varied as a function of the degree of relation with the probands. The clinical expression of JME among probands from India is fairly similar to that reported in probands of different ethnic backgrounds. The risk of relatives being affected as well as their risk of expressing a type of IGE (including JME) varies as a function of the degree of relation with the probands. The reduced occurrence of febrile convulsions among the relatives of JME probands probably represents an ascertainment bias. A much larger database of this type should be helpful in understanding the interactions of different genes that are believed to be responsible for some of the inherited human epileptic syndromes like JME and other IGEs.

Low incidence of febrile convulsion during the acute phase of Kawasaki disease in Japan

Central nervous system complications in Kawasaki disease (KD) have been rarely described [2,3]. However, since KD is a highly febrile, systemic vasculitis syndrome, is often accompanied with aseptic meningitis, and usually affects children under 5 years of age [1], we hypothesised that febrile convulsion (FC) may occur in a substantial proportion of KD patients. To determine the incidence of FC in KD patients, we reviewed 217 KD patients (M/F: 80/137) admitted to the Nishi-Kobe Medical Centre between July 1994 and December 2004. Patient ages ranged between 1 month and 10 years with 175 (80.6%) and 206 (94.9%) subjects being £ 3 and £ 5 years of age, respectively. There was only one patient, a 1-year-8-month-old girl, with FC. Thus, the incidence of FC in our series was estimated as 0.46% (1/217). We reviewed the English literature and found three reports on this issue [2, 3,5], all of which were conducted in Japan. Patient number in each study was 155 [2], 540 [3], and 177 [5], and there has been only one patient, a 5year-old boy [2], with FC among them. On meta-analysis of our series and these reports, the incidence was 2/ 1089 (0.18%, 95% CI: 0.02%–0.66%). When limited to patients £ 5 years of age, a predominant period for FC, this figure was somewhat higher; however, the lack of age distribution in previous studies [3,5] precluded precise determination. In any case, the incidence was unexpectedly low, compared to an epidemiological finding on the FC prevalence (8.3%) at 3 years of age in Japan [4]. We found an extremely low incidence of FC in KD in Japan. This estimate, however, may not be applicable to other regions because of wide geographic differences in the prevalence of KD and FC [1,4].

Clinical expression and EEG features of patients with juvenile myoclonic epilepsy (JME) from North India

We aimed to characterize the clinical profile, EEG features and response to treatment of juvenile myoclonic epilepsy (JME) patients. We studied 103 JME probands with a standard protocol recording age of onset, type, frequency of seizures, EEG data, detailed family history and response to treatment in a superspeciality university hospital in New Delhi. The mean age of onset of disease was 14.01 ±3.14 years with a male to female ratio of 1.19 : 1. The myoclonic jerks were present in all the probands, generalized tonic–clonic seizures (GTCS) were present in 75.72% and 11.65% probands had absence seizures. The incidence of febrile convulsion (FC) was higher (9.7%) in our JME probands reflecting some ethnic variation or ascertainment bias. There was a considerable delay (of approximately 5.26 ±4.61 years) in the diagnosis of JME in our probands because most of the patients were referred from private physicians who were possibly not familiar with this epileptic syndrome in this part of the world or thought it was a milder variety of GTCS. The family history was positive in 25.24% JME probands among first- and second-degree relatives. An interictal EEG was found to be abnormal in 81 (78.64%) patients with the predominant abnormality being generalized polyspike and wave (PSW) discharges (39.80% probands). The majority of patients (80.58%) showed a good response to treatment with valproate alone. There was a subset of patients (11.65%) who required the addition of other antiepileptic drugs (AEDs) for control of GTCS: 7.76% of JME patients were diagnosed as cases of GTCS by private practitioners before they were registered in our study and their seizures were well controlled on other AEDs (without valproate) prescribed by the referring physicians (carbamazepine-4, phenytoin-2, clobazam-2). It is concluded that the clinical features and EEG data of JME probands were comparable to reports from other parts of the world except for the fact that the incidence of FC was higher in our JME patients. There was a delay in the diagnosis of JME due to unfamiliarity with the epileptic syndrome among private practitioners in this part of the world. There was a subset of JME patients who had complete seizure control on other AEDs besides valproate.

The influence of long-term treatment with histamine H1 receptor antagonists and theophylline on the incidence of febrile convulsion in children with atopic dermatitis and/or asthma

The influence of long-term treatment with histamine H1 receptor antagonists and theophylline on the incidence of febrile convulsion in children with atopic dermatitis and/or asthma

Febrile convulsions with focal sharp waves: A subgroup of benign partial epilepsies of childhood with multifactorial etiology

Studies on the prognosis of febrile convulsions (FC) have scarcely considered the heterogeneity of FC and its relationship to the risk and the variable nature of subsequent afebrile seizures. Meaningful study of this issue requires a sample of FC children that is as homogeneous as possible. One such FC subgroup is children with focal sharp waves (shw) in the electroencephalogram (EEG) of a type characteristic of benign partial epilepsies (5%–10% of all FC children). Because the incidence of FC is elevated in children with benign partial epilepsy, the question arises whether these entities have certain pathogenetic mechanisms in common. Because only children with long-term follow-up are suitable for a study of these problems, the results obtained here allow no quantitative inferences regarding prognosis. Inclusion criteria were: 1) FC as the first seizure symptom; 2) focal shw characteristic of benign partial epilepsy; 3) first EEG before the fifth year of life; 4) at least four EEGs between the second and the eighth year of life. One-hundred and twenty-eight children were ascertained. Duration of follow-up ranged from 1–33 years. A positive family history of seizures was found in 34% of probands. The incidence of neonatal seizures was remarkably elevated (6%). Prolonged FC and FC with focal symptoms were significantly overrepresented. Long lasting FC (>60 minutes) were associated with an occipital location of the shw. Fifty-nine children suffered subsequent afebrile seizures or epilepsy (selected material): idiophathic partial epilepsy (58%); idiopathic generalized epilepsy (12%); severe epilepsies (22%), usually with intractable complex partial seizures. The latter were clearly associated with FC lasting longer than 1 hour. In 91% of the patients generalized genetic EEG patterns like generalized spikes and waves, photoparoxysmal response, and theta rhythms were eventually detected. Among the shw findings, precentral (70%) and occipital (50%) foci predominated. Of 69 investigated siblings focal shw were detected in 14%. Febrile convulsions with focal shw represent a multifactorial disorder. The combined action of five factors seems relevant: 1) a hereditary impairment of brain maturation (represented by the shw-EEG trait); 2) a genetic anomaly expressed by photoparoxysmal response; 3) a genetic cortical hypersynchronization (theta rhythms); 4) the generalized spike wave abnormality; and 5) a genetic predisposition to FC that is represented by a high incidence of FC in relatives but is not expressed specifically in the EEG. Subsequent epilepsies are idiopathic (mostly partial) or the consequence of FC lasting more than 1 hour.

Febrile Convulsions and Congenital Hypothyroidism

The incidence of febrile convulsions (FCs) among 63 children with congenital hypothyroidism (CH) was compared to that of control children and patient’s siblings in a study at Niigata University, Japan.

Incidence of febrile convulsions in children with congenital hypothyroidism

Brain excitability has been inconsistently reported to be increased both in hypo‐ and hyperthyroidism, but there have been few studies on the effects of thyroid hormones on brain excitability in children. With this in mind, we investigated the incidence of febrile convulsions (FCs) among patients with congenital hypothyroidism, who have been taking L‐ thyroxine since the age of 1 month. The incidence of FCs among congenital hypothyroid patients was 1.6% (1/63) which was significantly low (p < 0:05) compared with that of normal control children who visited our hospitals as outpatients (28/341, 8.2%) and that of others (322/3301, 9.8%) investigated 33 years ago in the same area. The incidence of FC among siblings of the 63 patients (7/74, 9.5%) was not statistically different from the controls. At least 8 of the 126 parents (6.4%) had experienced FC, however, only one child was affected in the 8 families. In conclusion, it seems likely that patients with congenital hypothyroidism on regular L‐T4 replacement are less prone to experience FC. More studies on the incidence of convulsive disorders in children with thyroid diseases are needed to clarify the effects of thyroid hormones on brain excitability.

Incidence of febrile convulsions in children with congenital hypothyroidism

Brain excitability has been inconsistently reported to be increased both in hypo- and hyperthyroidism, but there have been few studies on the effects of thyroid hormones on brain excitability in children. With this in mind, we investigated the incidence of febrile convulsions (FCs) among patients with congenital hypothyroidism, who have been taking L-thyroxine since the age of 1 month. The incidence of FCs among congenital hypothyroid patients was 1.6% (1/63) which was significantly low (p < 0.05) compared with that of normal control children who visited our hospitals as outpatients (28/341, 8.2%) and that of others (322/3301, 9.8%) investigated 33 years ago in the same area. The incidence of FC among siblings of the 63 patients (7/74, 9.5%) was not statistically different from the controls. At least 8 of the 126 parents (6.4%) had experienced FC, however, only one child was affected in the 8 families. In conclusion, it seems likely that patients with congenital hypothyroidism on regular L-T4 replacement are less prone to experience FC. More studies on the incidence of convulsive disorders in children with thyroid diseases are needed to clarify the effects of thyroid hormones on brain excitability.

Low incidence of febrile convulsions in children with congenital hypothyroidism regularly receiving thyroid hormone

Low incidence of febrile convulsions in children with congenital hypothyroidism regularly receiving thyroid hormone

Significance of Bisynchronous Spike‐Waves in Patients with Temporal Lobe Spikes

We examined the clinical significance of bisynchronous spike-wave complexes which appear in EEGs of some patients with focal spikes in one or both temporal lobes. Few features distinguished patients with bisynchronous spike-waves from those with only focal temporal spikes: a higher incidence of patients with more than two grand mal seizures a year (43 vs. 7%) and a younger age at last recording (22.5 vs. 28.3 years) were the only statistically reliable factors. Proportion of patients with complex partial seizures (CPS) (100%), age of CPS onset, incidence of febrile convulsions, intellectual level, and normal neurologic examination were features common to the two groups. In contrast to other studies which did not exclude influencing variables such as extratemporal spike foci, our group with bisynchronous spike-waves fared equally well after temporal lobectomy as did patients with temporal spikes alone. All 6 patients with spike-waves obtained a reduction of at least 50% in seizure frequency and 5 of the 6 (83%) had a greater than 90% reduction. Sixteen of 17 patients (94%) without spike-waves had a reduction of at least 50% and 14 of the 17 (82%) had a greater than 90% reduction of seizures.

Neonatal hypoxia and epileptic risk: a clinical prospective study.

A historical cohort study was undertaken to determine the risk of epilepsy in a population of 371 newborns with an acute neurological disorder related to fetal and/or neonatal hypoxia compared with a control population of 362 normal newborns. The results showed that the risk of epilepsy was 5.1 times higher in the group of subjects affected at birth by a hypoxia-related acute neurological syndrome than in the control group. (Although the incidence of epilepsy is higher in the first year of life, epileptic seizures connected to perinatal hypoxia may occur in early childhood or later on.) Also, there were frequently persistent neuropsychiatric disorders in children with perinatal hypoxia (5.4%). There was no difference in the two groups regarding the incidence of febrile convulsions. The data show that perinatal hypoxia plays a role in the etiology of epilepsy, although at birth the hypoxia might result in only a modest and oftentimes completely reversible neurological syndrome.

Febrile convulsions in inbred strains of mice susceptible and resistant to audiogenic seizures.

The incidence of febrile convulsions was determined in six inbred strains of mice at four ages. Febrile convulsions were elicited by placing the mice in a cylinder with the air temperature raised to 51 +/- 2 degrees C; this elevated the mouse's body and brain temperature to between 40 and 46 degrees C. The strains used were DBA/2Bg, DBA/1Bg, DBA/1Bg-ras, C57BL/10Bg, C57BL/6Bg, and C57BL/6Bg-Gad-1 alpha; the ages were 21 +/- 1, 29 +/- 1, 59 +/- 1, and 119 +/- 1 days of age. DBA/2Bg, DBA/1Bg, and C57BL/6Bg-Gad 1 alpha are audiogenic seizure susceptible at 21 +/- 1 and 29 +/- 1 days of age, but not at 59 +/- 1 and 119 +/- 1 days of age; whereas C57BL/10Bg, C57BL/6Bg, and DBA/1Bg-ras are audiogenic seizure resistant at all ages. Mice of both sexes, all strains, and all ages had a febrile convulsion and died. Thus, in inbred mice, there does not appear to be either a genetic or developmental correlation between audiogenic seizures and febrile convulsions. This finding may be contrasted with that in other studies showing a correlation between susceptibility to audiogenic seizures and to either electroshock convulsions or chemoconvulsions. However, there are subtle strain and age variants in susceptibility to febrile convulsions of these mice.

A genetic study of febrile convulsions.

307 probands with febrile convulsions classed as the simple type (131 children) and the complicated type (176 children) were genetically analyzed. There was a tendency toward familial aggregation of febrile convulsions, and genetic involvement was suggested. The multifactorial mode of inheritance best agreed with the observations. (1) The ratio of incidence of febrile convulsions in siblings of probands in the present study (19.9%) to the incidence in the general population (2.9%), i.e., 6.85, was rather close to the expected ratio of 5.87 from the multifactorial inheritance system. (2) The incidence in siblings tended to be higher when either or both of their parents had a history of febrile convulsions. In 2-child families where the first child was affected, the incidence in the second child tended to increase in parallel with the increasing incidence in parents. (3) The incidence in siblings was higher if probands were males. (4) The heritability, when estimated by Falconer's procedure, was as high as 76%, showing that febrile convulsions are strongly genetically predisposed. These findings were more distinctly observed in the simple type than in the complicated type.

Genetic aspects of febrile convulsions.

A total of 6706 children 3 years of age (3491 boys, 3215 girls) in a particular geographical area in Fuchu (population approximately 182 000), Tokyo, was investigated. Some 654 children (9.8%; 10.5% for male, 9.0% for female) had had at least one convulsion, and the incidence of febrile convulsions was 6.7% (7.2% for male, 6.2% for female). The 450 FC children with febrile convulsions and 620 randomly selected control children were analyzed on the mode of inheritance. The incidence of the disease among siblings was 21.9% (29.7% after age correction), which rose greatly with increasing numbers of affected family members, and the segregation ratio among siblings was higher (36.5%) with one FC parent, and lower (18.5%) if neither parent had had a seizure. The more severe the illness in FC children, the larger the incidence among siblings. Population and family studies indicated that heredity plays an important role in febrile convulsions and that multifactorial inheritance is most likely.

Genetic factors in febrile convulsions. An investigation of 64 same-sexed twin pairs.

The importance of genetic factors in the aetiology of febrile convulsions (FC) has been evaluated from a study of 64 same-sexed twin pairs and their siblings. The twin pairs were selected from a twin population of 1631 normal same-sexed twin pairs. Eight of the 26 monozygotic (MZ) pairs were concordant with respect to FC, while the non-proband of one further MZ pair suffered from petit mal epilepsy. Five of the 37 dizygotic (DZ) pairs were concordant with respect to FC. The pairwise concordance rates for the MZ and DZ series were 0.28 and 0.11 respectively (chi2= 1.82, 0.10 < p < 0.20), while the MZ and DZ proband concordance rates were 0.46 and 0.20 respectively. The MZ pairwise concordance rate of 0.57 was significantly higher than the DZ concordance rate of 0.09 in the 30 female pairs (chi2= 5.77, 0.01 < p < 0.02). The incidence of FC in sibs of the propositi was 14%. The combination of a high risk of FC in the sibs of the propositi and the non-significant difference between the concordance rates in MZ and DZ pairs indicates that FC are caused by factors shared by sibs, but that these factors are to a great extent of a non-genetic nature. However, the separate analysis of the female pairs demonstrates the existence of genetic aetiological factors.