Jakub Gécz, Richard Nagy, Lucia Švecová, Margaréta Gecíková
Introduction: Febrile seizures are typical for childhood. Their onset is mostly sudden and unexpected. In hospitals, we see them rarely, but we meet children shortly after febrile seizures quite often.
Goals: The aim of our work was to retrospectively look at the care given to children after febrile seizures at the DPE NICD (Department of paediatric emergency, National institute of children’s diseases) in Bratislava. We wanted to evaluate the awaited benefit of changes in the management of children after febrile seizures. We compared a period of 6 years.
Cohort and methods: The cohort consists of every child treated in DPE NICD in Bratislava due to febrile seizures in the years 2012 nad 2018. We looked at their age, sex, seasonal occurrence, type of seizures, etiology, the onset of seizures after first fever, treatment given at home or before arrival to the DPE, treatment given at the DPE, number of neurology examinations and further destiny of the children. We have also evaluated recommendation of benzodiazepines as prevention of febrile seizures.
Results: We have treated 91 children after febrile seizures at the DPE NICD in the year 2012 and 136 in 2018. Average age was just above 26 months in both years with boys taking the bigger part. The highest incidence was in winter and spring. More than 80% of children arrived to the hospital via ambulance. In both years approximately 90% of seizures were simple. Etiology of fever was mostly viral. In half of the children, febrile seizures occurred in less than six hours after the onset of fever. In 2012 88% of children were hospitalized even though only 5% suffered complicated febrile seizures. In 2018 it was less than half (41%) of children who stayed in hospital. Diazepam as prophylaxis was recommended to 82% of children in 2012. It was zero in 2018 and the number of returns to hospital has not changed anyway. In 2012, as well as in 2018, only two children have returned to hospital after they were released home from DPE.
Conclusion: We can certainly say that even though recent management, when compared to the previous one, looks more brave and maybe less precize, is equally effective. Children are less traumatized with hospital stays and they are not unnecessarily intoxicated with benzodiazepines.