A Clinical Study of Febrile Convulsions in Children Over 5 Year Olds without Organic Problems

Huh, Jae Kyung; Choi, Jun Seok; Park, Ho Jin

Abstract

PURPOSE
Febrile convulsions are the most common form of childhood seizures, appearing between in children 3 months and 5 years of age and are predominantly of benign nature. Febrile convulsions occurring after 5 years of age might be estimated as epilepsy. Most data for these disorders are from mainly epilepsy populations and might not be relevant to these children, and the requirement of any specific treatment or workup is not yet established either. Thus we tried to obtain a unique perspective.
METHODS
Clinical data for episodes of febrile convulsions were collected in Eulji hospital in Deajeon. These were obtained from anonymised copies of a standardised admission note, emergency, nursing, and intensive care unit notes and interviews with parents, medical, nursing, and paramedic staff.
RESULTS
Finding of 259 episodes of febrile seizure in over 5 year olds. 121(46.7%) were confirmed epilepsy or afebrile seizure in under 5 year olds, 13(5.0%) were caused by infection, metabolic disorder, leukemia and so on, and 23(8.9%) had previous neurological defect. Lastly, 102(39.4%) were included to febrile convulsion in over 5 year olds. 28(27.5%) of the subjects had their initial febrile convulsions in children over 5 year olds while 74(72.5%) of the subjects were under 5 years of age. The male to female ratio of the seizure group was 2:1. In the duration and type of convulsions, generalized convulsions occurred predominantly within 15mins in both of them. 5(17.9%) of group A and 16(21.6%) of group B showed electroencephalogram abnormality. The most common causes of seizure were common colds. Most of the convulsions occurred less than 24hrs after fever but, there were no abnormal findings in lumbar puncture and brain MRI.
CONCLUSION
Febrile seizure in over 5 year olds without organic problems has similar characteristics to febrile convulsion in under 5 year olds. In light of these findings, lumbar puncture and brain MRI do not require a routine checkup for the evaluation of febrile seizure in over 5 year olds. However, encephalography needs to be examined.