| Objective:To study the distribution characteristics of day,night,time periods and seasons of the seizures of febrile seizures(FS)in children,and then to obtain the circadian rhythm and seasonal rhythm characteristics of the seizures of FS in children,so as to provide new ideas for the pathogenesis,prediction,treatment and diagnosis of FS in children.Methods:The clinical data of children who met the inclusion criteria of this study were collected from January 1,2016 to August 30,2019 from the outpatient and inpatient departments of the pediatric center of Zhujiang hospital of Southern Medical University.Taking the time of seizures of FS as the main research object,24 hours were divided into day,night and 12 time periods and 12 months were divided into four seasons,and then the distribution characteristics of day,night,time periods and seasons of the seizures of FS was analyzed.According to gender,perinatal history,neurodevelopmental history,and family history of FS,the children were divided into the boy group and girl group,normal perinatal history group and abnormal perinatal history group,normal neurodevelopmental group and abnormal neurodevelopmental group,family history negative group and family history positive group,to analyze the difference of distribution characteristics of day and night,time periods and seasons of the seizures with different groups.This study also analyzed the characteristics of interval time between a seizure and next seizures in children with multiple seizures within 24 hours.Results:1.In this study,124 children with FS were enrolled,with 220 FS and 291 seizures,with an average of 1.77 FS per person and 2.35 seizures per person.75 boys and 49 girls,boys:girls=1.53:1.The onset age of 83.87%children was from 6 months to 3 years old,while the average onset age was 23.10 months.2.There was no significant difference in the distribution of the number of seizures between in day and at night(P=0.238).The distribution of the number of seizures between in day and at night had no significant difference with the boy group(P=0.759),normal perinatal history group(P=0.376)and abnormal perinatal history group(P=0.462),normal neurodevelopmental group(P=0.404)and abnormal neurodevelopmental group(P=0.07),family history negative group(P=0.304)and family history positive group(P=0.632),but the girl group had more seizures in day(P=0.018).3.The number of seizures from 11:00-22:59 was significantly higher than at 23:00-10:59(P<0.0001),So the high frequency area of seizures was at 11:00-22:59,and the low frequency area of seizure was at 23:00-10:59.The distribution of high and low frequency area of seizures hadn't changed with the boy group(P=0.002)and girl group(P<0.0001),normal perinatal history group(P<0.0001)and abnormal perinatal history group(P=0.002),normal neurodevelopmental group(P<0.0001),family history negative group(P<0.0001)and family history positive group(P=0.017).However,there was no significant difference on the frequency of seizures between 11:00-22:59 and 23:00-10:00 for the children with abnormal neurodevelopmental(P=0.763).4.There were two peak times of seizures at 11:00-12:59 and 19:00-20:59 and a trough time of seizures at 01:00-02:59(P<0.0001).The distribution of the peak and trough times of seizures hadn't changed with normal neurodevelopmental group(P=0.001).But the trough time was at 03:00-04:59 in the boy group(P=0.037),the girl group had only one peak time at 17:00-18:59(P=0.009),two peak times were at 11:00-12:59 and 17:00-18:59 for the children with the normal perinatal history group(P=0.023)and family history negative group(P=0.007).However,the abnormal perinatal history group(P=0.104),abnormal neurodevelopmental group(P=0.187),and family history positive group(P=0.064)had no peak or trough times of seizures.5.220 FS were recorded in four seasons,and the peak season of FS in summer and the trough season of that in autumn(P=0.002).The distribution of peak and trough seasons of FS hadn't changed with the boy group(P=0.045),normal perinatal history group(P=0.002),normal neurodevelopmental group(P=0.013),and family history negative group(P=0.005).However,the girl group(P=0.048)and the abnormal neurodevelopmental group(P=0.041)had peak season of FS in spring and summer and the trough season in autumn.The abnormal perinatal history group had peak season of FS in spring and the trough season in winter(P=0.035).But the family history positive group had no peak and trough seasons(P=0.152).6.41 children(33.06%)including 24 boys and 17 girls had two or more convulsions within 24 hours.There were 59 recurrent seizures within 24 hours,including 18 in the first hour after a seizure,9 in the second hour after a seizure,5 in the third hour after a seizure,6 in the fourth hour after a seizure,5 in the fourth hour after a seizure and 16 in the fifth hour over 5 hours after a seizure.Discussion:We found that the seizures of FS in children had circadian rhythm and seasonal rhythm which was affected by gender,perinatal,neurodevelopmental,family history of FS.Moreover,the possibility of reoccurrence in the first hour after a seizure of FS is the greatest.The exploration of characteristics of circadian rhythm and seasonal rhythms of seizures of FS in children will provide new ideas for the prediction,prevention and treatment of FS in children. |
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