بررسی عوامل خطر در عود تشنج با تب در کودکان مراجعه‌کننده به بیمارستان کودکان حضرت علی‌اصغر(ع)

    Background and Aim: Febrile convulsion is one of the common problems in children aged between5 months to 6 years old.While some areas have a prevalence rate of 10%, world prevalence is only2-4%. Although world wide studies show that the use of anticonvulsive drugs like Phenobarbital may decrease the rate of seizure attacks, but it may be associated with multiple complication such as behavior disorders, learning disability, drowsiness, dizziness and ataxia. Positive family history, severity and frequency of seizure, degree of fever, age of onset of seizure, developmental delay, and abnormal neurological exam are the factors that influence the recurrence of seizure. The goal of this study is the evaluation of the risk factors for recurrence of febrile convulsion, its correct management, prevention of the future attacks and its complication.   Materials and Methods: This is a prospective discretional study. Out of 432 patients aged under 15 yrs that had referred with febrile convulsions to the Neurology clinic of Hazrat-e Ali Asghar Hospital in a period from December 2003- December 2005, 103 children with "recurrent febrile convulsion" were selected on the basis of history, physical examination, clinical and paraclinical findings recorded in a questionnaire especially prepared for the recognition of risk factors for recurrence of febrile convulsion.   Results: In this study, 62% were males and 34% (39) were girls.As the tables show, patients under the age of one year made up most of the cases (37 patients, 35%).Meanwhile, 48 patients had temperatures between 38 to 39 ° c at the onset of the seizure and time duration between the fever and oset of seizure in 44% of the cases was more than 1 hour. In 24(23.5%) of cases, the first episode of seizure lasted for 15-20 minutes and in less than 10% of patients the duration of the seizure was less than 5 minutes. Also, 57.5 % of the patients had generalized tonic-clonic seizures and in 68.5% seizure attacks recurred twice.The most frequent causes of fever in this study were upper respiratory tract infections (31.75%) and lower respiratory tract infection (14.5%), respectively. In paraclinical evaluation, 72% of the EEGs, 41% of the MRIs and 34% of the CTscans were abnormal. Forty eight patients (46.5%) had problems such as asphyxia and meconium aspiration at the time of birth, 25% had developmental delay and 42% has abnormal neurological examination. Finally, 37.8% of the children were the result of familial marriage.   Conclusion: This study shows that positive family history of febrile seizure, young age, short duration between fever and onset of seizure, abnormal neurological examination, developmental delay, and abnormal EEG can be risk factors in recurrence of febrile convulsion, and it is necessary to consider these factors in children with febrile convulsion.