Pediatr Emerg Med J.  2023 Oct;10(4):118-123. 10.22470/pemj.2023.00752.

Clinical aspects of patients visiting the emergency department with febrile seizure

• Kim JM
• Hwang HY
• Lee JH
• Kim MK
• Lee SM

• KMID: 2546285
• DOI: http://doi.org/10.22470/pemj.2023.00752

Abstract

Purpose
We aimed to analyze the clinical characteristics, recurrence, neurological outcomes, and the impact of coronavirus disease 2019 pandemic in children who visited 2 emergency departments (EDs) with febrile seizure (FS).
Methods
We retrospectively reviewed medical records of 3,172 episodes, involving 2,510 children aged 6-60 months whose diagnoses were FSs at the EDs in 2 hospitals from 2013 through 2022. Through the review, we analyzed clinical characteristics and associated factors for the recurrence of FS. As a sub-analysis, the variables were compared between before (2017-2019) and during (2020-2022) the pandemic.
Results
A total of 3,172 FS-related visits to the EDs were found in 2,510 children. Of these, 890 children (35.5%) underwent recurrences of FS. The recurrence of FS was associated with boys (63.3% vs. 57.8%; P = 0.007), seizures lasting longer than 5 minutes (16.6% vs. 12.7%; P = 0.007), family history of FS (23.7% vs. 16.2%; P < 0.001), complex FS (13.3% vs. 8.0%; P < 0.001), and epilepsy diagnosed thereafter (9.1% vs. 3.0%; P < 0.001). During the pandemic, we noted a decrease in the number of FS-related visits to the EDs (from 1,274 to 383), an increase in the percentage of complex FS (9.3% vs. 13.8%; P = 0.012), and a decrease in the percentage of recurrent FS (49.4% vs. 33.4%; P < 0.001), compared to before the pandemic.
Conclusion
Our study identified factors associated with recurrence of FS, and confirmed the increase in complex FS with the decrease in the recurrence during the coronavirus disease 2019 pandemic. These findings could be helpful when caring for children with FS in EDs.

Keyword

COVID-19; Epidemiology; Epilepsy; Recurrence; Seizures, Febrile

Figure

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  Fig. 1. Annual trend of febrile seizure-related visits from 2013 through 2022. It shows a decrease in 2018-2020, followed by a slight rebound since the start of coronavirus disease 2019 pandemic (arrow).

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  Fig. 2. Monthly trend of febrile seizure-related visits. As for the total (solid line) and during 2013-2019 (dotted line), frequent visits are noted in January and April with troughs in October. Overall decrease is noted in the visits during 2020-2022 (dash line) in comparison with 2013-2019 (dotted line).

Reference

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