[fr] Résumé : Les convulsions fébriles (CF), malgré leur bénignité,
font toujours l’objet de discussions concernant les investigations
à entreprendre et l’attitude thérapeutique à adopter.
Notre étude vise à faire l’inventaire des éléments cliniques
et paracliniques présents lors de survenue des CF et susceptibles
d’en influencer la prise en charge. 275 épisodes de CF
admis aux Urgences Pédiatriques du CHR sur une période
de 5 ans ont été analysés rétrospectivement sur la base des
circonstances de survenue, des caractéristiques cliniques, des
examens paracliniques et de la prise en charge immédiate. Les
CF représentent 1,4% des admissions pédiatriques. Un antécédent
familial a pu être retrouvé dans 31,3 % des épisodes.
9% des crises étaient latéralisées, 11,7% étaient répétitives et
12,3% ont duré plus de 10 minutes. Les infections des voies
respiratoires supérieures et otorhinolaryngologiques d’origine
virale étaient les plus incriminées: 69,5%. Les explorations
paracliniques étaient normales dans plus de 90 % des cas.
L’évolution était spontanément favorable dans 73,8% des cas.
Un anticonvulsivant a été nécessaire pour les 26,2 % restants.
Notre travail confirme le caractère bénin de la majorité des
CF et leur évolution favorable. La réalisation des examens
complémentaires et l’indication d’un traitement antiépileptique
doit reposer principalement sur l’analyse des signes de
gravité. [en] Summary : Febrile Seizures (FS), despite their usual benign
clinical course, are still subject of controversies regarding the
need for further investigation and treatment with anti-epileptic
drugs (AEDs). Our study aimed to inventory the clinical
findings, laboratory and imaging data associated with FS and
eventually influencing their management. 275 episodes admitted
with FS at the emergency ward of the Liège CHR over a
5 year period were retrospectively analyzed regarding precipitating
factors; clinical features; laboratory, electroencephalographic,
and imaging studies; as well as treatment response.
FS represented 1.4% of admissions to the pediatric service.
31.3% of patients had a family history of seizure disorder. 9%
percent of seizures were focal, 11.7% recurrent, and 12.3%
prolonged (greater than 10 minutes). Upper respiratory tract
and otorhinolaryngologic viral infections were the most often
implicated provoking factors, occurring in 69.5% of patients.
Laboratory, electroencephalographic and radiographic studies
were normal in more than 90% of cases. 73.8% of seizures
resolved without intervention. An AED was required to manage
the remaining 26.2%. This study confirms the favorable
outcomes of FS as demonstrated in previous studies. This
happens without requiring AEDs for resolution, and without
recurrence. Laboratory, electroencephalographic and imaging
studies, as well as initiation of AEDs should be based primarily
on clinical severity.
Disciplines :
Pediatrics
Author, co-author :
KAPUTU, Kalala Malu CELESTIN; Université de Liège - ULiège > service universitaire de neuropédiatrie, CHR Citadelle, Liege
MAFUTA, Musalu ERIC; Université de Kinshasa > Ecole de Santé publique
DUBRU, Jean-Marie ; Centre Hospitalier Universitaire de Liège - CHU > Pédiatrie
LEROY, Patricia; Université de Liège - ULiège > Service universitaire de neuropédiatrie, CHR Citadelle, Liège
TOMAT, Anne-Marie ; Université de Liège - ULiège > service universitaire de pédiatrie, CHR Citadelle, Liège
Misson, Jean-Paul ; Université de Liège - ULiège > Département des sciences cliniques > Pédiatrie
Language :
French
Title :
ÉPIDÉMIOLOGIE ET CARACTÉRISTIQUES DES CONVULSIONS FEBRILES DE L'ENFANT
Alternative titles :
[en] Epidemiology and characteristics of febrile seizures in children
Publication date :
April 2013
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Belgium
Daoud, A., Febrile Seizures : Review Article (2008) J Med J, 42, pp. 170-173
Freeman, J.M., Febrile seizures: A consensus of their significance, evaluation, and treatment. Consensus development conference of febrile seizures 1980 (1980) National Institute of Health. Pediatrics, 66, pp. 1009-1012
Guidelines for epidemiologic studies on epilepsy.- Commission on Epidemiology and prognosis, international league against epilepsy (1993) Epilepsia, 34, pp. 592-596
Van Stuijvenberg, M., De Vos, S., Tjiang, G.C., Parents' fear regarding fever and febrile seizures (1999) Acta Paediatr, 88, pp. 618-622
Ofovwe, G.E., Ibadin, O.M., Ofovwe, E.C., Home management of febrile convulsion in an African population: A comparison of urban and rural mothers' knowledge attitude and practice (2002) J Neurol Sci, 200, pp. 49-52
Lai, N.M., Tan, M.L., Quah, S.Y., Over-investigated and under-treated: Children with febrile convulsion in a Malaysian district hospital (2010) Singapore Med J, 51, pp. 724-729
Callegaro, S., Titomanlio, L., Donega, S., Implementation of a febrile seizure guideline in two pediatric emergency departments (2009) Pediatr Neurol, 40, pp. 78-83
Pedespan, L., Convulsions hyperthermiques (2007) Arch Pediatr, 14, pp. 394-398
Verity, C.M., Golding, J., Risk of epilepsy after febrile convulsions : A national cohort study (1991) BMJ, 303, pp. 1373-1376
Motte, J., (2010) Convulsions Fébriles, pp. 293-296. , Chabrol B, Dulac O, Mancini J, Ponsot G Ed., Neurologie Pédiatrique. Flammarion médecine-sciences, Paris
Kundu, G.K., Rabin, F., Nandi, E.R., Etiology and risk factors of febrile seizure - An update. Bangladesh (2010) J Child Health, 34, pp. 106-124
Waruiru, C., Appleton, R., Febrile seizures : An update (2004) Arch Dis Child, 89, pp. 751-756
Nguefack, S., Ngo Kana, C.A., Mah, E., Aspects cliniques etiologiques et thérapeutiques des convulsions fébriles. A propos de 325 cas a Yaoundé (2010) Arch Pediatr, 17, pp. 480-485
Dulac, O., (2001) Convulsions et Épilepsie du Nouveau-né et du Nourrisson, pp. 369-406. , Arthuis M, Dulac O, Ponsot G, Pinsard N, Mancine J Ed., Neurologie Pédiatrique Flammarion médecine-sciences, Paris
Annegers, J.F., Blakley, S.A., Hauser, W.A., Recurrence of febrile convulsions in a population-based cohort (1990) Epilepsy Res, 5, pp. 209-216
Van Stuijenberg, M., Steyerberg, E.W., Derksen-Lubsen, G., Temperature age and recurrence of febrile seizures (1998) Arch Paediatr Adolesc Med, 152, pp. 1170-1175
Manfredini, R., Vergine, G., Boari, B., Circadian and seasonal variation of first febrile seizures (2004) J Pediatr, 145, pp. 838-839
Kmc, K., Mafuta, E.M., Le-A, O., Seizures associated with fever and psychomotor development in primary health care in Kinshasa (2012) Ann. Afr. Med, 5, pp. 1106-1111. , http://hdl.handle.net/2268/129679
Kmc, K., Mafuta, E.M., Le-A, O., Short term outcome of seizures associated with fever in children in primary health care in Kinshasa (2012) Afr J Neurol Sci, 31, pp. 23-33
Chung, B., Wong, V., Relationship between five common viruses and febrile seizure in children (2007) Arch Dis Child, 92, pp. 589-593
Hampers, L.C., Thompson, D.A., Bajaj, L., Febrile seizure: Measuring adherence to aap guidelines among community ed physicians (2006) Pediatr Emerg Care, 22, pp. 465-469
Carroll, W., Brookfield, D., Lumbar puncture following febrile convulsion (2002) Arch Dis Child, 87, pp. 238-240
Stores, G., When does an EEG contribute to the management of febrile seizures? (1991) Arch Dis Child, 66, pp. 554-557
Garvey, M.A., Gaillard, W.D., Rusin, J.A., Emergency brain computed tomography in children with seizures : Who is most likely to benefit? (1998) J Pediatr, 133, pp. 664-669
Lee, P., Kate Verrier, J., Urinary tract infection in febrile convulsions (1991) Arch Dis Child, 66, pp. 1287-1290
