| Objective Febrile seizure(FS)is a febrile convulsion in children.It is a common nervous system emergency with obvious age dependence.The course of most children is benign.A small number of children with recurrent seizures may have brain damage,which affects their cognitive,learning and memory functions,and some even develop epilepsy.The purpose of this study is to investigate the relationship between the characteristics of video electroencephalogram(VEEG)and the prognosis of febrile convulsion recurrence and secondary epilepsy,so as to clarify the clinical application value of VEEG in the prognosis of febrile convulsion.Video electroencephalogram was examined regularly in children with febrile convulsion.The seizure situation of children was followed up and video electroencephalogram was monitored.Objective to compare the relationship between seizure recurrence and epilepsy in normal and abnormal EEG group,specific and non-specific EEG group,to study the relationship between different discharge sites of VEEG and epilepsy,to study the seizure frequency and duration in 3 years in normal and abnormal EEG group,and to reveal the relationship between the characteristics of video EEG and the prognosis of FS children,so as to clarify the clinical significance of VEEG in the prognosis of febrile seizures It is beneficial to the implementation of the clinical pathway of febrile convulsion,and is also fully prepared for the prevention of epilepsy.Methods Methods from January 1,2015 to December 31,2017,650 children with febrile convulsion in the Department of Neurology of Shenyang children’s hospital were selected.The clinical data of febrile convulsion children were collected,including gender,age,family history of first-degree relatives,seizure type,seizure duration,seizure frequency and clinical classification.All children were examined by video electroencephalogram at the end of one week.The video electroencephalogram was recorded by Cadwell easy III video electroencephalograph for 2-3 hours,including at least one complete sleep cycle.According to the results of VEEG,the patients were divided into normal EEG group and abnormal EEG group;the abnormal EEG group was divided into non-specific abnormal group(localized or diffuse slow wave)and specific abnormal group(Interictal epileptiform discharges(IEDs)including sharp wave,spike wave,spike slow wave and spike slow wave);according to the discharge location,the patients were divided into three groups: parietooccipital lobe,frontotemporal lobe and generalized discharge.Methods: 650 children with febrile convulsion were followed up for 1 year,2years and 3 years after the first diagnosis.The follow-up included the recurrence times and duration of febrile convulsion,the results of video EEG examination,and the occurrence of epilepsy.If the child does not return to the hospital within the specified time,three telephone inquiries are unanswered or the parents refuse to return to the hospital,it will be considered as lost.Excel was used to input system data,and ssps 21.0 was used for data analysis.The counting data was expressed as cases or percentage,and X2 test or Fisher’s exact probability method was used for comparison between groups;the measurement data was expressed as mean ± standard deviation((?) ± s),and t test was used for comparison between two groups,P < 0.05 was considered as statistically significant.Results1.General information In this study,586 children with febrile convulsion were successfully followed up,and 64 children with febrile convulsion were lost to follow-up,with a loss rate of9.85%.Among the 586 children with febrile convulsion,321(54.78%)were male and265(45.22%)were female,the ratio of male to female was 1.2:1.0;the age ranged from3 months to 6 years old,among which 302(51.54%)were ≤ 3 years old,284(48.46%)were > 3 years old,the average age was(4.30 ± 1.80)years old;384 cases had the first attack,202 cases had recurrent attack;219 cases had family history of FS37%),45 cases(7.68%)had family history of epilepsy,3 cases(0.52%)had both FS and family history of epilepsy,320 cases(54.61%)had simple febrile seizure(SFS)and266 cases(54.39%)had complex febrile seizure(CFS).2.Characteristics of video EEG In 586 children with FS,398 cases(67.92%)had normal EEG,including boundary changes;188 cases(32.08%)had abnormal EEG,including 66 cases(20.63%)with simple febrile convulsion and 122 cases(45.86%)with complex febrile convulsion.The abnormal EEG group can be divided into non-specific abnormal group and specific abnormal group.136 cases(23.21%)in non-specific abnormal group showed extensive or local slow wave.In the specific abnormal group,52 cases(8.87%)showed generalized spike slow wave discharges,epileptiform discharges in occipital,frontal and temporal regions.Among them,10 cases(19.23%)in the parietooccipital lobe discharge group,17 cases(32.69%)in the frontotemporal lobe discharge group and 25cases(48.07%)in the extensive discharge group were collected according to different discharge sites.After 3 years of follow-up,115 cases(19.62%)still had abnormal video EEG.(1)Comparison of recurrence frequency and duration of FS in 3 years between VEEG normal group and VEEG abnormal group The frequency of FS recurrence within 3 years in the abnormal video EEG group(6.30 ± 1.20)was significantly higher than that in the normal video EEG group(2.10± 0.30)(P < 0.05);the duration of each seizure in the normal video EEG group(26.80± 5.20)was significantly shorter than that in the abnormal video EEG group(83.50± 12.30)s(P < 0.05).(2)Comparison of VEEG results between simple and complex febrile seizures before and after follow-up In 320 cases of simple febrile convulsion,66 cases(20.63%)had abnormal VEEG before follow-up,and 40 cases(12.50%)had abnormal VEEG after 3 years of follow-up;in 266 cases of complex febrile convulsion,122 cases(45.86%)had abnormal VEEG before follow-up,and 75 cases(28.20%)had abnormal VEEG after follow-up.According to the simple and complex febrile convulsion in children before and after follow-up VEEG abnormal rate comparison,the difference was statistically significant(P < 0.05).(3)Comparison of FS recurrence and secondary epilepsy between VEEG normal group and VEEG abnormal group398 children with normal video EEG were followed up for 3 years,of which 109(27.39%)had FS recurrence and 8(2.01%)had secondary epilepsy;188 children with abnormal video EEG were followed up for 3 years,85(45.21%)had FS recurrence and27(14.36%)had secondary epilepsy.The recurrence rate of FS and the incidence of epilepsy in the normal group and the abnormal group were compared,and the difference was statistically significant(P < 0.05).(4)Comparison of FS recurrence and epilepsy between specific abnormal group and non-specific abnormal group Among 188 cases of abnormal video EEG,there were 52 cases in the specific abnormal group and 136 cases in the non-specific abnormal group.In 52 cases of specific abnormal group,25 cases had febrile convulsion recurrence(48.07%),18 cases developed epilepsy(34.62%);in 136 cases of non-specific abnormal group,60 cases had febrile convulsion recurrence(44.17%),9 cases developed epilepsy(6.62%).There was no significant difference in the recurrence rate of FS between the two groups(P >0.05),but there was significant difference in the incidence of epilepsy(P < 0.05).(5)Comparison of the relationship between different discharge sites and the outcome of epilepsy Fifty two children with abnormal video EEG at different discharge sites were followed up,among them,18 children developed epilepsy;in 25 cases of generalized discharge group,4 cases developed epilepsy(16.00%);in 17 cases of frontotemporal discharge group,11 cases developed epilepsy(64.70%);in 10 cases of parietooccipital discharge group,3 cases developed epilepsy(30.00%);in the late stage of frontotemporal discharge,3 cases developed epilepsy The difference was statistically significant(P > 0.05).Conclusions1.The frequency of recurrence of febrile convulsion in children with abnormal EEG was higher than that of normal video EEG children,and the duration of convulsion was long.2.Compared with the follow-up,the abnormal rate of video EEG in the two groups was decreased.3.The recurrence of febrile convulsion and secondary epilepsy in children with abnormal EEG were more likely.4.The risk of secondary epilepsy in children with EEG specific abnormality was significantly higher than that of non-specific abnormal children,and the prognosis of children with specific abnormal EEG was poor.5.Discharge of frontal temporal lobe is a risk factor for secondary epilepsy in children with febrile convulsion. |
PDF Full Text Request