Journal Information
Vol. 80. Issue 6.
Pages 365-369 (01 June 2014)
Vol. 80. Issue 6.
Pages 365-369 (01 June 2014)
Original Article
DOI: 10.1016/j.anpede.2013.06.003
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Complex febrile seizures: Study of the associated pathology and practical use of complementary tests
Crisis febriles complejas: estudio de la patología asociada y utilidad de las pruebas complementarias
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R. Berzosa Lópeza, J.M. Ramos Fernándezb,??
Corresponding author
dr.jmramos@gmail.com

Corresponding author.
, J. Martínez Antónb, M.G. Espinosa Fernándeza, A. Urda Cardonaa
a Hospitalización Pediatría, Unidad de Gestión Clínica de Pediatría, Hospital Materno Infantil Carlos Haya, Malaga, Spain
b Sección Neuropediatría, Unidad de Gestión Clínica de Pediatría, Hospital Materno Infantil Carlos Haya, Malaga, Spain
Article information
Abstract
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Abstract
Introduction

Although one third of febrile seizures are complex, a consensus has still not been reached on how to manage them, as is the case with simple febrile seizures. The objective of this study is to estimate the usefulness of complementary examinations and the risk of associated serious intracranial pathology.

Patients and methods

A retrospective review was conducted from 2003 until 2011 on patients from 6 months to 6 years presenting with a complex febrile seizure admitted to a tertiary care hospital, excluding the cases with previous neurological disease. Epidemiological and clinic variables were collected, as well as complementary tests and complications.

Results

We found 65 patients (31 females and 34 males), of whom 44 had repeated seizures in the first 24hours, with 15 having focal seizures. The vast majority (90%) of the recurrences occurred before 15hours. The mean age was 20.7 months and temperature was 39.1 ± 0.12°C. None of the patients had severe intracranial pathology. The electroencephalogram gave no helpful information for the diagnosis. Neuroimaging was normal in all studied cases.

Conclusions

The incidence of complications in complex febrile seizure in our series did not justify the systematic admission or the systematic study with complementary tests when the neurological examination was normal. The routine electroencephalogram does not appear to be justified.

Keywords:
complex febrile seizure
Seizures
Fever
Epilepsy
Management
Resumen
Introducción

Un tercio de las crisis febriles son complejas. Su manejo no ha suscitado un consenso como en el caso de las crisis febriles simples. El objetivo de este estudio es estimar la rentabilidad de los exámenes complementarios y el riesgo de enfermedad intracraneal grave asociada.

Pacientes y métodos

Estudio retrospectivo desde el año 2003 hasta el 2011 de los pacientes ingresados en un hospital de tercer nivel con criterios de convulsión febril compleja de 6 meses a 6 años, excluyendo los casos con afección neurológica previa. De los pacientes seleccionados, se recogieron variables epidemiológicas, clínicas, pruebas complementarias y complicaciones.

Resultados

Se encontró a 65 pacientes (31 mujeres y 34 varones) de los cuales 44 tuvieron crisis repetidas en las primeras 24h y 15 presentaron crisis focales. El 90% de la recurrencia ocurrió antes de 15h. La edad media fue de 20,7 meses y la temperatura fue de 39,1 ± 0,12°C. En ningún paciente se encontró afección intracraneal grave durante su ingreso. El electroencefalograma no ofreció información de ayuda para su diagnostico. La neuroimagen fue normal en todos los casos estudiados.

Conclusiones

La incidencia de complicaciones en la convulsión febril compleja en nuestra serie no justificó el ingreso ni el estudio sistemático con pruebas complementarias cuando la exploración neurológica era normal. El electroencefalograma de rutina no parece estar justificado.

Palabras clave:
Crisis febril compleja
Convulsiones
Fiebre
Epilepsia ;Manejo
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Please cite this article as: Berzosa López R, Ramos Fernández JM, Martínez Antón J, MA Espinosa Fernández, Urda Cardona A. Crisis febriles complejas: estudio de la patología asociada y utilidad de las pruebas complementarias. An Pediatr (Barc). 2014;80:365-369.

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