Convulsiones febriles simples y complejas, ¿son tan diferentes? Manejo y complicaciones en urgencias / Simple and complex febrile seizures: is there such a difference? Management and complications in an emergency department
Neurología (Barc., Ed. impr.)
; 37(5): 317-324, Jun. 2022. ilus, tab
Article
em En, Es
| IBECS
| ID: ibc-205981
Biblioteca responsável:
ES1.1
Localização: ES15.1 - BNCS
RESUMEN
Objetivo:
Analizar la prevalencia, características y manejo de las convulsiones febriles simples y complejas. Secundariamente, comparar el riesgo de lesión orgánica subyacente y epilepsia entre ambos tipos de crisis y particularmente de cada subtipo que define una convulsión febril compleja. Material ymétodo:
Estudio de cohortes retrospectivo que incluye pacientes de 0-16 años que consultan por convulsión febril en urgencias pediátricas de un hospital terciario durante 5 años. Se recogen variables epidemiológicas y clínicas. Se realiza un seguimiento posterior mínimo de 2 años para confirmar el diagnóstico final.Resultados:
Se incluyeron 654 convulsiones febriles, con una prevalencia del 0,20% (IC 95% 0,18-0,22%); 537 fueron simples (82%) y 117 complejas (18%). Las características clínico-epidemiológicas de ambos tipos fueron similares. En las formas complejas se solicitaron significativamente más pruebas complementarias en forma de analíticas (71,8% vs. 24,2%), tóxicos (10,3% vs. 2,4%), punción lumbar (14,5% vs. 1,5%) y TAC (7,7% vs. 0%). Igualmente se indicó ingreso con mayor frecuencia (41,0% vs. 6,1%). No se diagnosticó ninguna lesión orgánica subyacente (infección del sistema nervioso central, enfermedad metabólica, tumor/lesión intracraneal ocupante de espacio, intoxicación) excepto 11 casos de epilepsia, 5 de ellas en las formas complejas (4,3%; IC 95% 0,6-7,9%). En el análisis multivariable presentaron mayor riesgo de desarrollar epilepsia las formas complejas por ser recurrentes en el mismo proceso febril (odds ratio [OR] 4,94; IC 95% 1,29-18,95), aquellos con antecedentes de crisis previas (OR 17,97; IC 95% 2,26-143,10) y las manifestadas a edades atípicas (OR 11,69; IC 95% 1,99-68,61).Conclusiones:
No está justificada la indicación sistemática de pruebas complementarias o ingreso en las convulsiones febriles complejas. El riesgo de epilepsia en las formas complejas hace necesario el seguimiento en neuropediatría. (AU)ABSTRACT
Objective:
We aimed to analyse the prevalence, characteristics, and management of simple and complex febrile seizures. The secondary objective was to compare the risk of underlying organic lesion and epilepsy in both types of seizures, with a particular focus on the different subtypes defining a complex febrile seizure. Material andmethods:
We performed a retrospective cohort study including patients aged 0-16 years who were treated for febrile seizures in the paediatric emergency department of a tertiary hospital over a period of 5 years. Epidemiological and clinical variables were collected. Patients were followed up for at least 2 years to confirm the final diagnosis.Results:
We identified 654 patients with febrile seizures, with a prevalence of 0.20% (95% CI, 0.18-0.22); 537 (82%) had simple febrile seizures and 117 (18%) had complex febrile seizures. The clinical and epidemiological characteristics of both types were similar. Significantly more complementary tests were requested for complex febrile seizures blood tests (71.8% vs 24.2% for simple febrile seizures), urine analysis (10.3% vs 2.4%), lumbar puncture (14.5% vs 1.5%), and CT (7.7% vs 0%). Similarly, admission was indicated more frequently (41.0% vs 6.1%). Underlying organic lesions (central nervous system infection, metabolic disease, tumour/intracranial space-occupying lesion, intoxication) were diagnosed in only 11 patients, 5 of whom had complex forms (4.3%; 95% CI, 0.6-7.9). Risk factors for developing epilepsy, identified in the multivariate analysis, were complex forms with recurrent seizures in a single attack (odds ratio [OR] 4.94; 95% CI, 1.29-18.95), history of seizures (OR 17.97; 95% CI, 2.26-143.10), and seizures presenting at atypical ages (OR 11.69; 95% CI, 1.99-68.61).Conclusions:
The systematic indication of complementary tests or hospital admission of patients with complex febrile seizures is unnecessary. [...] (AU)Palavras-chave
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- https://www.sciencedirect.com/science/article/pii/S0213485319300799
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Texto completo:
1
Base de dados:
IBECS
Assunto principal:
Convulsões Febris
/
Epilepsia
Limite:
Adolescent
/
Child
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Child, preschool
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Humans
/
Infant
Idioma:
En
/
Es
Ano de publicação:
2022
Tipo de documento:
Article