Abstracts

Febrile seizures are the most common convulsive event in children younger than 5 years of age. Despite the progress in understanding this benign epilepsy syndrome, a wide variation in physician evaluation and management persists. Our objective is to evaluate the clinical approach and outcome of children admitted with febrile seizures in our institution.
A series of 69 consecutive children with febrile seizures were identified by chart review from 1997 to 2001. Clinical, laboratory, EEG, and neuroimaging data were evaluated. One investigator retreived all the data using a structured data collection form.
The children[rsquo]s ages ranged between 7-70 months (mean 20, SD 14), and 59.5% were males. The source of the febrile illness was evident in 65%, however, most admitted children (60 out of 69) had atypical seizures (55%), were ill looking (24.5%), had febrile status (17.5%), or positive meningeal irritation signs (4%). Electrolyte abnormalities were uncommon (10%), however, complete blood count (CBC) was abnormal in 45% and increasing the likelihood of receiving IV antibiotics (p=0.01). Lumbar puncture was performed on 75%, particularily those who presented with a first seizure compared to recurrent seizures (OR 3.8, 95%CI 0.9-15). Brain CT and electroencephalograms (EEG) were performed in 13% and 33% respectively. Obtaining an EEG was less likely if the seizure was typical (13% vs 50% in atypical, p=0.002). Duration of hospitalization ranged between 1-14 days (mean 4.7, SD 3.2), and only 1 child had meningitis, which was predicted clinically.
Pediatricians are selective in admitting children with febrile seizures to hospital. Admitted children frquently had atypical seizures, status, or were ill looking. The yeild of investigations remain low and does not justify extensive work-up.