Risk Factors For Secondary Epilepsy In Children With Febrile Seizure Within 2 Years

Convulsion is one of the most common clinical emergencies,which occurs most frequently in children.There are many causes of convulsion,among which febrile convulsion and epilepsy are the most common.Hot convulsion(febrile seizure,FS)is associated with fever,in children convulsion as the main performance of clinical events,often occurred in 3months to 5 years old children,its long-term adverse consequences is rare,however before diagnosis must rule out other causes of seizure,such as intracranial infection,acute electrolyte imbalance,especially in infants and young children(excluding other factors are particularly important).Most FS children have a good prognosis after active symptomatic treatment,but children,especially infants,are in the stage of rapid growth and development,and the development of brain neurons is incomplete,and recurrent seizures of febrile convulsion or convulsions lasting for a long time can cause nerve cell destruction,and there is a risk of secondary epilepsy.Currently,there are many literatures related to febrile convulsion,but there are different reports on the incidence and risk factors of epilepsy secondary to febrile convulsion.To this end,183 children with febrile seizures who were admitted to the inpatient department or outpatient department of the Affiliated Hospital of Chengde Medical College and followed up regularly were selected in this study to observe whether they had secondary seizures within 2 years,collect relevant clinical data,and conduct correlation analysis to find the risk factors for secondary seizures of febrile seizures.Objective:To explore the high risk factors of secondary epilepsy in children within2 years after febrile seizures.Methods:Data of 183 children with first febrile seizure(FS)admitted to the Affiliated Hospital of Chengde Medical College from January 2018 to January2019 were collected,and related data were collected,including general information: gender,age,onset season,family history of febrile seizure,family history of epilepsy,and perinatal conditions,etc.Clinical data: time of attack,type of attack,number of first 24 hours of convulsion,duration of convulsion,maximum body temperature during seizure,results of electroencephalogram,primary infectious diseases,infection indexes,secondary epilepsy within 2 years,etc.According to whether the children with febrile convulsion had secondary epilepsy or not,they were divided into the epileptic group and the non-epileptic group.First,univariate analysis was conducted for each clinical factor,and then Cox regression analysis was conducted for statistically significant clinical factors to explore the risk factors for secondary epilepsy in children with febrile convulsion within 2 years.Results:1.Among the 183 cases of FS,males were the most common,accounting for 66.12%;The duration of febrile convulsion ≤5min accounted for49.72%;Among the FS types,simple FS was the most common,accounting for 73.77%.Upper respiratory infection was the most common disease causing FS,accounting for 69.95%.2.According to whether the secondary epilepsy,clinical factors respectively for the single factor analysis,and to have statistical significance of orderly classification variables do orderly classification of two variable correlation chi-square test shows: the first thermal seizure and the younger,have a family history of epilepsy,seizures,the highest temperature,the lower the longer the duration,type of attack,attack the more complex,attack times >2 times,abnormal electroencephalogram(eeg)in children with secondary epilepsy risk is higher,differences were statistically significant(P < 0.05).3.There were no significant differences in CRP,WBC,PCT and Neut %between epilepsy group and non-epilepsy group(P > 0.05).4.2 years as a time node,whether as a result,secondary epilepsy to the single factor analysis of statistically significant variables as covariate multiariable COX regression analysis,the result shows: have a family history of epilepsy,the highest temperature of 40 ℃ or less during the attack,complexity,convulsions,hot sex first hot seizure eeg abnormalities is children independent risk factors for the development of secondary epilepsy,the difference was statistically significant(P < 0.05)..Conclusions:1.Children with younger age,family history of epilepsy,lower maximum body temperature,longer duration of seizure,more complex type of seizure,> 2 times of seizure,and abnormal EEG are at higher risk of secondary epilepsy.In addition,family history of epilepsy,lower body temperature during seizure,complex febrile convulsion and abnormal EEG were independent risk factors for secondary epilepsy in children with febrile convulsion.2.The level of infection index is not a risk factor for epilepsy secondary to febrile convulsion.