Journal articles on the topic 'Febrile convulsions Treatment'
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1
Lagenstein, I., and B. Rothe. "Recurrence of Febrile Convulsions and Phenobarbital Treatment." Acta Paediatrica 74, no. 2 (March 1985): 294–95. http://dx.doi.org/10.1111/j.1651-2227.1985.tb10969.x.
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Ingram, T. T. S. "THE TREATMENT OF FEBRILE CONVULSIONS IN CHILDHOOD." Developmental Medicine & Child Neurology 15, no. 4 (November 12, 2008): 531–33. http://dx.doi.org/10.1111/j.1469-8749.1973.tb05080.x.
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Rylance, G. W. "Treatment of epilepsy and febrile convulsions in children." Lancet 336, no. 8713 (August 1990): 488–91. http://dx.doi.org/10.1016/0140-6736(90)92025-d.
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S., Srinivasa, Syeda Kausar Anjum, Shruthi Patel, Harish S., and Bhavya G. "Parental knowledge, attitude and practices regarding febrile convulsion." International Journal of Contemporary Pediatrics 5, no. 2 (February 22, 2018): 515. http://dx.doi.org/10.18203/2349-3291.ijcp20180546.
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Background: Febrile convulsion is a condition which can emotionally traumatize most parents. Inadequate knowledge regarding febrile convulsion can cause parental anxiety. This study is conducted to assess the level of parent’s knowledge, attitude and practices regarding febrile convulsion.Methods: It was a prospective questionnaire study conducted over a period of one year from January 2016 to January 2017 in Department of Paediatric of a tertiary care hospital KIMS, Bangalore. 110 children with febrile convulsion in the age group of 6 months to 5 years were enrolled.Results: Out of 110 children, 82 had single convulsion and 28 had recurrent convulsions. Mean age of onset of first febrile convulsion was 20 months. About 50 (45.45%) had experienced convulsion with one-episode of fever. Only 46 (41.8%) of parents recognized convulsion. Others interpreted convulsion as shivering (20.9%), evil effect (7.2%), excessive cry tantrum (10.9%), fainting spell (8.18%) and lethargy (20%). 88 (80%) did not carry out any intervention prior to getting the child to hospital. Effect of convulsion on parents was fear of death (82.7%), fear of epilepsy (17.3%), fear of recurrence (34.5%). 85% parents did not know that convulsion can occur due to fever. 32% thought that traditional treatment would help. Only 38% had thermometer at home and 23% knew the normal range of body temperature. Preventive measures were known to 44%.Conclusions: A higher level of understanding regarding practices was shown among higher socioeconomic and higher educational status. The efficiency of parental first aid practices can be evaluated and significant improvement can be achieved by giving adequate awareness and education.
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Ramakrishna, Jayashree, William R. Brieger, and Joshua D. Adeimiyi. "Treatment of Malaria and Febrile Convulsions: An Educational Diagnosis of Yoruba Beliefs." International Quarterly of Community Health Education 9, no. 4 (January 1989): 305–19. http://dx.doi.org/10.2190/yu03-nekj-ttt3-rx0p.
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An understanding of community perceptions of illness, especially disease definitions that are unique to a particular culture, is essential for developing culturally appropriate primary health care programs. Malaria is endemic in the Ibarapa District of Oyo State, Nigeria, and one of its major complications, febrile convulsions, affects nearly one-third of preschool children at least once in their lifetime. Perceptions among the local Yoruba people categorize malaria and convulsions as part of two different disease processes. Ideas of causation, severity, seasonality, and treatment are in many ways opposites. This means that parents do not perceive the dangers of convulsions when their children suffer malaria. Unfortunately the small children themselves cannot be part of the decision-making process which involves potentially toxic treatment practices. Based on an understanding of Yoruba beliefs, primary health care and health education interventions have been designed that encourage parents to take prompt action when they recognize that their child has malaria.
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Student. "AGAIN, THE PERFIDY OF SMALL CLINICAL TRIALS." Pediatrics 83, no. 5 (May 1, 1989): A63. http://dx.doi.org/10.1542/peds.83.5.a63.
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The analysis [of British trials of phenobarbitone and valproate for the prophylactic treatment of febrile convulsions] shows well how small study groups serve to exaggerate benefits of drawbacks of treatment. All the trials have been too small for paediatricians to use their findings with confidence.
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Kumar, Vinod, and Ashish Gupta. "Intermittent clobazam prophylaxis in simple febrile convulsions: a randomised controlled trial." International Journal of Contemporary Pediatrics 6, no. 2 (February 23, 2019): 732. http://dx.doi.org/10.18203/2349-3291.ijcp20190720.
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Background: Febrile seizure (FS) is the most common type of childhood seizure disorder with a prevalence of 2-5% in children less than 5 years. Although the prognosis of febrile seizure is usually good, however, the possibility of recurrence keeps many parents and families in a state of anxiety and concerned, for years after the first seizure. Thus, intermittent prophylactic treatment might be advised in children with high risk of recurrence.Methods: The study was a prospective randomized, double blind, placebo-controlled trial conducted at Department of Pediatrics, Umaid Hospital, Dr S N Medical College, Jodhpur on neurologically normal children aged from 6 months to 5 years with a history of simple febrile seizures and normal electroencephalogram without any evidence of acute central nervous system infection. Subjects were randomly prescribed oral clobazam according to weight of child and placebo when they developed a febrile disease during the first 48 h of the onset of fever. Temperature reduction measures with paracetamol and tepid sponging were also advised. Patients were followed up for the frequency and time of febrile seizure recurrence, febrile episodes and side effects of drugs for 12 months.Results: Ten (3.8%) of 257 episodes in clobazam group and 38 (14.07%) episodes in placebo group had seizure recurrence (p value <0.001). The two groups were not significantly different in terms of side effects. (p >0.05).Conclusions: Intermittent oral clobazam therapy is a very effective measure in preventing recurrence of febrile seizures.
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LEE, KIRSTEN, KAREN TAUDORF, VIBEKE HVORSLEV, and Birgitta Jailing. "Prophylactic Treatment with Valproic Acid or Diazepam in Children with Febrile Convulsions." Acta Paediatrica 75, no. 4 (July 1986): 593–97. http://dx.doi.org/10.1111/j.1651-2227.1986.tb10256.x.
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Abou-Khalil, Bassel, Eva Andermann, Frederick Andermann, Andre Olivier, and L. Felipe Quesney. "Temporal Lobe Epilepsy After Prolonged Febrile Convulsions: Excellent Outcome After Surgical Treatment." Epilepsia 34, no. 5 (September 1993): 878–83. http://dx.doi.org/10.1111/j.1528-1157.1993.tb02105.x.
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Masuko, Alice Hatsue, Aldemar Araujo Castro, Gustavo Rocha Santos, Álvaro Nagib Atallah, Lucila Bizari Fernandes do Prado, Luciane Bizari Coin de Carvalho, and Gilmar Fernandes do Prado. "Intermittent diazepam and continuous phenobarbital to treat recurrence of febrile seizures: a systematic review with meta-analysis." Arquivos de Neuro-Psiquiatria 61, no. 4 (December 2003): 897–901. http://dx.doi.org/10.1590/s0004-282x2003000600001.
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Convulsions triggered by fever are the most common type of seizures in childhood, and 20% to 30% of them have recurrence. The prophylactic treatment is still controversial, so we performed a systematic review to find out the effectiveness of continuous phenobarbital and intermittent diazepam compared to placebo for febrile seizure recurrence. METHOD: Only randomized, double-blind, placebo-controlled trials were analyzed. The recurrence of febrile seizure was assessed for each drug. RESULTS: Ten eligible clinical trials were included. Febrile seizure recurrence was smaller in children treated with diazepam or phenobarbital than in placebo group. Prophylaxis with either phenobarbital or diazepam reduces recurrences of febrile seizures. The studies were clinical, methodological, and statistically heterogeneous. CONCLUSION: The effectiveness of phenobarbital and diazepam could not be demonstrated because clinical trials were heterogeneous, and the recommendation for treatment recurrence should rely upon the experience of the assistant physician yet.
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Woollard, Malcolm, and Karen Pitt. "Antipyretic prehospital therapy for febrile convulsions: Does the treatment fit? A literature review." Health Education Journal 62, no. 1 (March 2003): 23–28. http://dx.doi.org/10.1177/001789690306200103.
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Sharma, Varun, Anaita Hegde, and Fazal Nabi. "Refractory status epilepticus: Febrile Illness Related Epileptic Syndrome (FIRES)." International Journal of Epilepsy 02, no. 02 (December 2015): 090–93. http://dx.doi.org/10.1016/j.ijep.2015.07.001.
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AbstractIn recent literature, a new entity has emerged, which focuses on a possible non-encephalitic epileptic encephalopathy precipitated by fever in a previously normal child. We report a typical case of Febrile illness related epileptic syndrome (FIRES) from Indian subcontinent. The index case presented with fever and multiple seizures, which progressed to status epilepticus and encephalopathy. All infectious, metabolic and autoimmune markers were negative. Convulsions were refractory to all possible treatment except thiopentone which achieved burst suppression pattern. Breakthrough seizures were prevented by using lacosamide and ketogenic diet along with multiple anticonvulsants. At 1-year follow-up, patient had a relatively good neurological outcome, however has persistent refractory epilepsy.
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Koli, Chandrashekhar, and Sachin Darne. "Review of seizure disorders in children in the age group of six months to five years." International Journal of Contemporary Pediatrics 5, no. 4 (June 22, 2018): 1236. http://dx.doi.org/10.18203/2349-3291.ijcp20182028.
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Background: Seizure disorder a term used to include epilepsy, febrile seizures and other types. The international classification and Diagnostic tools including EEG monitoring and MRI are helpful to categorize seizure and treat them with various antiepileptic medications.Methods: Data from patients in the age group of 6 months to 5 years, over 2 months period, presenting with seizure disorders was collected in prescribed proforma and evaluated for type of seizure disorder, age of onset, family history of seizures, previous history of febrile convulsions, presence of neurological abnormality, EEG changes and response to drugs. They were followed up over a period of 2 years.Results: In this study 200 children’s with seizure disorders from a period of 2 months, were screened, reviewed and followed up for a period of two years. Incidence of seizure disorder is 4.37% with male predominance. Of which febrile seizures (52.5%), Generalized Seizures (25.5%), partial seizures (12%), besides unclassified (10%) and status epilepticus (10%). 12% of the children had positive family history of epilepsy and 14.56% had history of previous febrile convulsion. Birth injuries (19.4%) and CNS infection (38.6%) and space occupying lesions (9.7%) constitute the major etiological factors. 10% patient with seizure disorder had abnormal neurological signs. EEG Examination showed 56.8% normal and 33.2% Generalized abnormality. On follow up 51% where found regular, out of which 30% went into remission.Conclusions: Seizure disorder is quite significant condition in children. Though benign, the febrile seizures are the most common type of seizure in children. The major preventable etiological factors for seizures are Birth trauma and CNS infections. Clinical and EEG work up is necessary for proper management of seizures. Health education is needed to stress the importance of regular treatment and to educate for removal of stigmata.
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Higuchi, Yousuke, Toshihide Kubo, Toshiharu Mitsuhashi, Naoko Nakamura, Ichiro Yokota, Osamu Komiyama, Isamu Kamimaki, et al. "Clinical Epidemiology and Treatment of Febrile and Afebrile Convulsions With Mild Gastroenteritis: A Multicenter Study." Pediatric Neurology 67 (February 2017): 78–84. http://dx.doi.org/10.1016/j.pediatrneurol.2016.05.011.
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Iorngurum, M. T., and M. T. C. Egri-Okwaji. "Prevalence and treatment of febrile convulsions in Paediatric Emergency Centre of Lagos University Teaching Hospital." Archives of Disease in Childhood 95, no. 6 (June 1, 2010): e1-e1. http://dx.doi.org/10.1136/adc.2010.190322.21.
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Jamali, Ameer, Waqas Ali, and Fazal Ur Rehman. "Comparison of phenobarbital and sodium valproate for the treatment of status epilepticus in children." Professional Medical Journal 27, no. 07 (July 10, 2020): 1353–57. http://dx.doi.org/10.29309/tpmj/2020.27.07.3543.
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Objectives: Seizure is considered to be one of the commonest emergency involving more than half of the admissions in Pediatric Neurology wards. It has been well documented that proper management not only improves the prognosis but also decrease complications in these children. This study was planned to compare phenobarbital against sodium valproate for the treatment of status epilepticus (SE) in children. Study Design: Randomized clinical trial. Setting: Emergency Department of Pediatrics Medicine, the Baqai University and Medical College, Karachi. Period: 15th July 2018 to 31st December 2018. Material & Methods: A total of 100 children (50 in each group) with seizure lasting longer than 5 minutes, aged 6 months to 12 years, did not respond to diazepam (0.2mg/kg) within five minutes, were enroll. Randomization was done using lottery system where Group A was nominated who used sodium valproate and Group B, phenobarbital. Good response was labeled if a child’s seizure was controlled within 20 minutes of treatment. Results: Out of total of 100 children included in the present study, there were 60 (60.0%) male and 40 (40.0%) female. Mean age of the children was 5.4 years with standard deviation of 2.2 years. As far as type of seizures are concerned, there were 43 (43.0%) children presented with febrile convulsions (FC) while 57 (57.0%) with SE. Overall, positive response was noted in 69 (69.0%) children. Response in between both the groups turned out to be of statistical significance as more children, 40 (80.0%) showed positive response in Group B in comparison to 29 (58.0%) in Group A (p value = 0.017). Amongst children with positive response, the difference between both the study groups was significant in relation to seizure types as 75.9% of children with SE showed positive response with sodium valproate while 52.5% children with FC showed positive response in Group B (p value=0.018). Conclusion: Overall, both study drugs showed good positive response but phenobarbital when compared to sodium valproate is a better choice for controlling seizure in pediatric population. Sodium valproate showed greater effectiveness when used in children with SE while phenobarbital was comparatively more effective in febrile convulsion.
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Ndu, Ikenna Kingsley, Chukwunonyerem Precious Duke-Onyeabo, Ngozi Nancy Onu, Oluebube Gloria Nnamani, and Chukwunonso Chigozie Iheji. "Traditional Uvulectomy: A common and potentially life-threatening practice in a developing country." Medical Science and Discovery 9, no. 8 (August 24, 2022): 450–53. http://dx.doi.org/10.36472/msd.v9i8.779.
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Objective: uvula. It is usually performed by non-medical personnel using mostly unsterile instruments. Notwithstanding the increasing number of health facilities, it is surprising that this aged-long crude practice with significant complications is still rampant in the 21st century. Material and Methods: This is a case series of four males with the age range of 5-months to four years who had traditional uvulectomy following febrile illnesses but with no improvement of symptoms. Thereafter, all presented late to our facility with diverse complications, including haemorrhage, infections, and convulsions. Three recovered fully following prompt treatment, however, one mortality was recorded. Conclusion: These cases highlight the life-threatening complications associated with traditional uvulectomy and the need for drastic measures to curtail the practice.
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Mosili, Palesa, Shreyal Maikoo, Musa, Vuyisile Mabandla, and Lihle Qulu. "The Pathogenesis of Fever-Induced Febrile Seizures and Its Current State." Neuroscience Insights 15 (January 2020): 263310552095697. http://dx.doi.org/10.1177/2633105520956973.
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Febrile seizures, commonly in children between the ages of 3 months to 5 years, are a neurological abnormality characterized by neuronal hyper-excitability, that occur as a result of an increased core body temperature during a fever, which was caused by an underlying systemic infection. Such infections cause the immune system to elicit an inflammatory response resulting in the release of cytokines from macrophages. The cytokines such as interleukin (IL)- 1β, IL-6, and tumour necrosis factor-α (TNF-α) combat the infection in the localized area ultimately spilling over into circulation resulting in elevated cytokine levels. The cytokines, along with pathogen-associated molecular patterns (PAMPs) expressed on pathogens for example, lipopolysaccharide (LPS), interact with the blood brain barrier (BBB) causing a ‘leaky’ BBB which facilitates cytokines and LPS entry into the central nervous system. The cytokines activate the microglia which release their own cytokines, specifically IL1β. IL-β interacts with the brain endothelium resulting in the activation of cyclooxygenase 2 which catalyzes the production of prostaglandin 2 (PGE2). PGE2 enters the hypothalamic region and induces a fever. Abnormally increased IL-1β levels also progressively increases excitatory (glutamatergic) neurotransmission, and decreases inhibitory (GABAergic) neurotransmission, thus mediating the pathogenesis of convulsions. Current treatments for febrile seizures present with side effects that are detrimental to health, which fosters the need for an alternative, more affordable treatment with fewer adverse side effects, and 1 that is easily accessible, especially in low income areas that are also affected by other underlying socio-economic factors, in which febrile seizures are of growing concern.
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Dominic, J. F., L. Kumar, V. Kochupillai, V. Raina, A. Sharma, S. Bakshi, T. Seth, and A. Kapil. "A randomized prospective open labeled study of oral amoxicillin-clavulanate with intravenous ceftriaxone and amikacin in low risk febrile neutropenia." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 18551. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.18551.
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18551 Background: Empiric oral antibiotic administration is a treatment option in low risk febrile neutropenia. Methods: Low risk febrile neutropenia patients (expected neutropenic duration <7 days with no comorbid features) between 15 and 75 years of age were randomized to receive either oral amoxicillin-clavulanate 625 mg twice daily and levofloxacin 500 mg once daily or intravenous (i.v.) ceftriaxone 2 g and amikacin 15 mg/kg once daily. Most patients were treated on out patient basis. The primary end point was response to therapy- defervescence of fever within 72 hours with improvement in any clinical manifestation of infection and no recurrence of fever for 48 hours without use of antipyretics. Use of growth factors was not permitted except in treatment failure. The study was cleared by the institute ethics committee. Results: Sixty four episodes in 53 patients were evaluable, 33 in the i.v. group and 31 in the oral antibiotics group. The underlying diagnosis was bone and soft tissue sarcomas in 32 episodes, hematological cancers in 22 and other solid cancers in 10. The groups were equally matched for age (median 25 years in the i.v. arm and 19 years in the oral arm), gender, type of cancer, baseline absolute neutrophil count (median 200/μL in both arms) and duration of neutropenia (5 days and 4 days in the i.v. and oral groups respectively). A focus of infection was identified clinically in 15% of episodes and microbiologically in 11% of episodes; 57% of which were gram positive organisms and the rest gram negative. Seventy two percent (95% confidence interval 58% to 88%) in the i.v. arm and 77% (95% confidence interval 63% to 92%) in the oral arm responded to therapy. The only serious toxicity was one episode of convulsions in the i.v. group. All treatment failures received second line i.v. antibiotics. There was no mortality in either group. Comparing the two groups for equivalence (assuming a 25% difference between the two arms as unequal) the two groups were found to be equivalent with a power of 59% (p = 0.03). Conclusion: Oral antibiotics have comparable efficacy as intravenous antibiotics in the management of low risk febrile neutropenia. No significant financial relationships to disclose.
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Temdrup, Thomas E. "Clinical Issues in Acute Childhood Seizure Management in the Emergency Department." Journal of Child Neurology 13, no. 1_suppl (October 1998): S7—S10. http://dx.doi.org/10.1177/0883073898013001031.
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Generalized tonic-clonic seizure activity in infants and children frequently leads to an emergency department visit, often after emergency medical service personnel, such as paramedics, provide initial evaluation and treatment. Important subsets of patients who present to the emergency department include those with non-seizure-mediated movements, those with nongeneralized seizure activity, those with complications of anticonvulsant therapy, and those with status epilepticus. Recognizing, diagnosing, and treating these conditions and minimizing complications are key issues to be considered in the refinement of emergency department practice. Of the children with seizures who are seen in the emergency department, those with febrile convulsions or exacerbations of underlying seizure disorders predominate, while those with new-onset epilepsy or other seizure disorders account for a smaller proportion. Current issues in the emergency department management of seizures in children include: (1) modifying interventions to stabilize patients and simultaneously minimize the physiologic deterioration accompanying generalized seizures; (2) selection, initiation, administration, and refinement of anticonvulsant therapy; (3) minimizing complications of prolonged seizures and their treatment; (4) rapid recognition and treatment of life-threatening illnesses that underlie seizure presentations; (5) selection of appropriate diagnostic measures; and (6) use of electroencephalography in selected patients. (J Child Neurol 1998;13(Suppl 1):S7-S10).
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Minja, B. M. "<p>Aetiology of deafness among children at the Buguruni School for the Deaf in Dar es Salaam, Tanzania</p>." Community Ear and Hearing Health 4, no. 5 (December 1, 2007): 9. http://dx.doi.org/10.56920/cehh.175.
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To identify the causes of deafness, 354 pupils attending the Buguruni School for the Deaf in Dar es Salaam, Tanzania, were studied. Of these children 205 were boys and 149 were girls, a sex ratio of 1.4:1. The onset of deafness was congenital in 36 (10.2%) and acquired in 318 (89.8%). Among the children with acquired deafness, the cause was unknown in 77 (24.2%); meningitis in 76 (23.9%); ototoxicity in 66 (20.8%); mumps in 53 (16.7%); febrile convulsions in five (1.5%), otitis media in 28 (8.8%) and measles in 13 (4.1%). Among the children with congenital deafness, only ten (27.8%) were identified before the age of 2 years. The findings indicate that most (75.8%) of the causes of acquired deafness are preventable through immunization, early diagnosis and proper treatment of ear infections and avoidance of prescription of ototoxic drugs. This emphasizes the need for programmes aimed at improving the health services at primary levels of health care which will in turn prevent deafness.
Published courtesy of: Int I Pediatr Otorhinolaryngol. 1998; 42(3):225-231
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Borghi, Rossella, Valentina Magliocca, Stefania Petrini, Libenzio Adrian Conti, Sandra Moreno, Enrico Bertini, Marco Tartaglia, and Claudia Compagnucci. "Dissecting the Role of PCDH19 in Clustering Epilepsy by Exploiting Patient-Specific Models of Neurogenesis." Journal of Clinical Medicine 10, no. 13 (June 23, 2021): 2754. http://dx.doi.org/10.3390/jcm10132754.
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PCDH19-related epilepsy is a rare genetic disease caused by defective function of PCDH19, a calcium-dependent cell–cell adhesion protein of the cadherin superfamily. This disorder is characterized by a heterogeneous phenotypic spectrum, with partial and generalized febrile convulsions that are gradually increasing in frequency. Developmental regression may occur during disease progression. Patients may present with intellectual disability (ID), behavioral problems, motor and language delay, and a low motor tone. In most cases, seizures are resistant to treatment, but their frequency decreases with age, and some patients may even become seizure-free. ID generally persists after seizure remission, making neurological abnormalities the main clinical issue in affected individuals. An effective treatment is lacking. In vitro studies using patient-derived induced pluripotent stem cells (iPSCs) reported accelerated neural differentiation as a major endophenotype associated with PCDH19 mutations. By using this in vitro model system, we show that accelerated in vitro neurogenesis is associated with a defect in the cell division plane at the neural progenitors stage. We also provide evidence that altered PCDH19 function affects proper mitotic spindle orientation. Our findings identify an altered equilibrium between symmetric versus asymmetric cell division as a previously unrecognized mechanism contributing to the pathogenesis of this rare epileptic encephalopathy.
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Gheța, Ioana, Raluca Ioana Teleanu, Eugenia Roza, Evelina Carapancea, Oana Vladacenco, and Daniel Mihai Teleanu. "GRIN2A Variant in A 3-Year-Old—An Expanding Spectrum?" Neurology International 13, no. 2 (April 29, 2021): 184–89. http://dx.doi.org/10.3390/neurolint13020018.
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Glutamate, the major excitatory neurotransmitter, plays a ubiquitous role in most aspects of normal brain functioning. Its indispensable position is paradoxically doubled by a high excitotoxic potential following disruption of its dynamic equilibrium. Several lines of evidence have suggested the involvement of the glutamatergic N-methyl-D-aspartate receptor (NMDAR) in learning, memory formation, and human cognition. Furthermore, NMDARs play a pivotal role in various neuropsychiatric disorders, recently being identified as an important locus for disease-associated genomic variation. The GRIN2A gene encodes the NMDAR’s GluN2A subunit. Genetic alterations of GRIN2A result in phenotypic pleiotropy, predisposing to a broad range of epilepsy syndromes, with an elusive and unpredictable evolution and response to treatment. The archetypal GRIN2A-related phenotype comprises the idiopathic focal epilepsies (IFEs), with a higher incidence of GRIN2A mutants among entities at the more severe end of the spectrum. We report the case of a patient heterozygous for GRIN2A, c.1081C>T, presenting with febrile convulsions and later superimposed atonic seizures, expressive language delay, and macrocephaly. As the number of reported GRIN2A variants is continuously increasing, the phenotypic boundaries gradually grow faint. Therefore, it is fundamental to maintain an acute critical awareness of the possible genetic etiology of different epilepsy syndromes. So far, therapeutic strategies rely on empirical observations relating genotypes to specific drugs, but the overall success of treatment remains unpredictable. Deciphering the functional consequences of individual GRIN2A variants could lead to the development of precision therapeutic approaches for patients carrying NMDAR mutations.
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Graf, William D., Gian-Emilio Chatrian, Stephen T. Glass, and Thomas A. Knauss. "Video Game-Related Seizures: A Report on 10 Patients and a Review of the Literature." Pediatrics 93, no. 4 (April 1, 1994): 551–56. http://dx.doi.org/10.1542/peds.93.4.551.
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Objective. To further describe the features, postulated pathophysiology, treatment, and outcome of seizures occurring while playing or watching video games (video game-related seizures (VGRS)). Design. We evaluated retrospectively 10 patients with VGRS seen by us and reviewed 25 reported cases. Results. The 35 patients ranged in age from 1 to 36 years (mean: 13.2); and 26 subjects (74%) were male. Eight individuals (29%) had prior infrequent nonfebrile seizures, 4 (11%) had febrile convulsions, and 2 (6%) had a family history of epilepsy. VGRS consisted of generalized tonic-clonic seizures in 22 of 35 individuals (63%); absences in 2 (6%); simple partial seizures in 6 (19%); complex partial seizures in 4 (11%); and other manifestations in 4. Neurologic examination and computed tomographic and magnetic resonance imaging scans were normal. Electroencephalograms demonstrated generalized or focal, interictal or ictal epileptic patterns in 11 of 21 patients (52%) and photoparoxysmal responses in 17 of 32 (53%). Eleven of 15 individuals (73%) treated with video game (VG) abstinence alone, 3 of 6 who received anticonvulsants but played VGs, and 7 of 12 treated with combined VG abstinence and anticonvulsants had no further seizures. Conclusions. We postulate that a special convulsive susceptibility of selected neurons in striate, peristriate, infratemporal, and posterior parietal cortices to particular visual stimuli plays a major role in VGRS. VG abstinence is the treatment of choice of VGRS. Anticonvulsant medication is suggested only for those individuals who continue to play VGs or suffer from seizures triggered by other, unavoidable visual stimuli, or from unprovoked attacks.
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Moussaid, Z., C. Khairoun, F. Benbrahim, N. El Hafidi, C. Mahraoui, L. Chatt, and S. Benchekroun. "ENCEPHALITES AIGUES INFECTIEUSES CHEZ LENFANT, EXPERIENCE DU SERVICE DES MALADIES INFECTIEUSES DE LHOPITAL DENFANT DE RABAT." International Journal of Advanced Research 10, no. 08 (August 31, 2022): 09–27. http://dx.doi.org/10.21474/ijar01/15145.
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Acute infectious encephalitis is a rare neurological pathology with a varied etiology and a serious prognosis. The purpose of this work is to report the experience of the pediatric infectious diseases department of the Childrens Hospital of Rabat in the management of this condition in order to identify the clinical, paraclinical, etiological, therapeutic and evolutionary and to determine the prognostic factors. Materials and Methods: This is a retro-prospective monocentric study, conducted from January 2014 to March 2019. Included in the study are children under 15 years of age, hospitalized for acute infectious encephalitis, confirmed or retained on presumption criteria. An operating sheet has been prepared for each file collecting epidemiological, clinical, paraclinical, therapeutic and progressive data and reported in an Excel sheet. Results : 60 cases have been collected. The average age of the patients is 4 years, the sex ratio M/F is 1.14. The onset of symptoms was acute in 77% of patients. The reason for consultation was fever (78%), convulsions (63%) and febrile disturbances of consciousness (13%). On admission, functional signs were dominated by fever (90%), disturbance of consciousness (53%), immediate coma (20% of cases) and convulsions (75%). The clinical examination found signs of deficit (43.33%), meningeal syndrome (20%), gait disturbances (16.6%), aphasia (2 cases), cerebellar syndrome (2 cases) and hypotonia (3 cases). Brain CT was instrumental in the diagnosis of encephalitis (26.4%), brain MRI (70%) and EEG (51%). The CSF analysis was pathological in 46% of the cases with a positive direct examination (1 case) and positive culture at MNO (1 case). PCR on CSF was positive in 25.6% of cases (HSV1: 5cases, EBV: 1 case, TB: 4cases). The etiology found was viral (50 cases: unknown germ (42 cases), HSV1 (5 cases), chickenpox (1 case), mumps virus (1 case), EBV (1 case)) and bacterial (10 cases: unknown germ (2 cases), MNO (2 cases), PNO (1 case) BK (5 cases)). Treatment was based on the etiology. Corticotherapy was recommended for 25 children and anticonvulsant treatment in all cases. Discussion: Despite its mono-centric nature and its time limitation, this series highlight the severity of acute infectious encephalitis in children. Viral encephalitis is the most common including herpetic encephalitis. The diagnostic difficulties are significant due to the routine unavailability of cerebral MRI and PCR in the CSF. However, a probabilistic treatment must be started without delay, the time to have more elements for the etiological orientation. Physicians awareness and the availability of these examinations remain essential for obtaining better results.
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Sothinathan, Pavithira, and Radha Kumar. "A study on parental perspectives towards childhood fever." International Journal of Contemporary Pediatrics 7, no. 1 (December 24, 2019): 144. http://dx.doi.org/10.18203/2349-3291.ijcp20195743.
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Background: Parents play an important role in recognizing and treating paediatric fever as well as initiating home treatment. Their knowledge and attitude can greatly influence paediatric fever treatment and parental phobia may at times lead to overtreatment of fever. Objectives of this study was to assess the knowledge, attitudes and practices of parents towards childhood fever. Methods: This cross-sectional observational study was conducted in the Paediatric department at Saveetha Medical College, Chennai. Data collection from parents was done using a questionnaire to study the knowledge, attitude and practices of parents towards fever and its management in children. Data analysis was done using SPSS 16 software.Results: Total 100 parents participated in the study, most of participants were mothers (69%) and 51% were between 20-30 years. 67% parents believed that fever could cause harmful effects like convulsions and delirium whereas 61% parents believed that consumption of large doses of antipyretic is harmful. Majority of parents 87% were aware that vaccinations can cause fever. Around 82% of parents declared that they had sleepless nights whenever their child was febrile. Majority of the parents 95% stated that they confirmed the presence of fever in their child by tactile assessment. About half the parents preferred using injections for reducing fever than oral medications.Conclusions: The study revealed presence of high levels of anxiety in majority of parents highlighting the need for reassurance and counsel ling by health professionals. Since most of the parents relied on tactile assessment for fever, there is a need to educate them about proper use of a thermometer for accurate detection and better assessment of fever.
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Malov, A. G., M. I. Vshivkov, and M. A. Mamunts. "DIFFICULTIES OF EARLY INFANTILE EPILEPTIC ENCEPHALOPATHY-9 DIAGNOSTIC." Russian neurological Journal, no. 3 (September 3, 2019): 24–30. http://dx.doi.org/10.30629/2658-7947-2019-24-3-24-30.
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Introduction: Early infantile epileptic encephalopathy (EIEE) is a group of monogenic epilepsies which are caused by mutations in more than 70 genes. Material and methods: The data of a long-term dynamic EEG observation of a girl with EIEE9 (OMIM 300088) caused by a mutation in the PCDH19 gene (OMIM 300460) are presented. Results: Correct etiological diagnosis of the hereditary disease was established only at the age of 14 years. Epilepsy debuted at the age of 8 months as a series of one minute long generalized tonic convulsions with myoclonia in the left arm. After further examination the symptoms were mistakenly regarded as viral encephalitis. Subsequently, clusters of convulsive seizures provoked by febrile states periodically were occurring several times per year irrespective of the type and amount of anticonvulsants taken. Despite the fact, that no significant structural changes in the brain we found during neuroimaging, pharmacoresistant focal epilepsy gradually developed. At the age of 14 years, as part of a pre-surgical examination for two days, the complete abolition of anticonvulsants and the implantation of subdural electrodes were performed. Focal motor seizures with a transition to bilateral tonic-clonic seizures were recorded, during which the primary generation of epileptic activity was localized in the left temporal lobe. А thorough examination with a clarification of the monogenic origin of the disease made it possible to avoid undue surgery on the brain. Discussion: The presented observation is a clear example of why a timely genetic examination is important for establishing correct diagnosis, adequate selection of anticonvulsants and a making a right decision on the possibility of surgical treatment.
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SKP, Kasiati, Hurun ain, Nurul Hidayah, and Faiqotul. "EFEKTIFITAS TEPID SPONGE BATH TERHADAP PENURUNAN SUHU TUBUH PADA ANAK KEJANG DEMAM DI RSUD LAWANG MALANG." Hospital Majapahit (JURNAL ILMIAH KESEHATAN POLITEKNIK KESEHATAN MAJAPAHIT MOJOKERTO) 14, no. 1 (February 1, 2022): 103–14. http://dx.doi.org/10.55316/hm.v14i1.767.
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A convulsion is a complaint that often makes a child come to the Accident and Emergency Department. Most febrile convulsion occurs due to fever. The treatment by nurses at the during of fever is to provide anti-pyretic’s drug according to the physician’s instructions and there is no non-pharmacological action in terms of lowering body temperature such as giving a warm compress (Tepid Sponge Bath). The purpose of this study is to know the effectiveness of Tepid Sponge Bath to decrease body temperature in children’s febrile convulsion in the Adenium’s room at RSUD Lawang. Design of the research used Quasi Experimental with the design type of Non-equivalent Control Group Design. The number of samples obtained as many as 26 respondents. The sample used Accidental Sampling Method. Measuring instrument for measuring body temperature in treatment group and control group used Digital Thermometer for forehead with 98% accuracy level. The result of statistical analysis of Independent Sample t-test showed no difference of body temperature at minute 30.60 and 90 after TSB, but at minute 45 and 120 there was significant difference (p value = 0,000 <0,05). The recommendation of this study is children who have fever to get Tepid Sponge Bath action because it can reduce the risk of febrile convulsion.
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Behir, Maryam Mohammed, Muhammad Saeed, and Aesha Farheen Siddiqui. "Dravet Syndrome -A case report from Aseer, Saudi Arabia." Bangladesh Journal of Medical Science 19, no. 2 (January 16, 2020): 315–18. http://dx.doi.org/10.3329/bjms.v19i2.45014.
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Dravet syndrome (DS) is an epileptic encephalopathy that presents with protracted seizures in infancy, associated with fever, and frequently categorized as febrile seizure at first presentation. In the second year, myoclonia, atypical absence and complex partial seizures develop. The correct diagnosis of DS and appropriate follow-up are delayed until after appearance of signs of developmental regression in the second year of life. Timely detection and diagnosis of DS followed by management with suitable anticonvulsants and treatment plan may reduce the seizure burden and improve long-term developmental outcome. We present a case of 2 years old female with recurrent attacks of generalized tonic colonic convulsion after 1st febrile convulsion diagnosed as Dravet syndrome. The diagnosis was based on history and gene study (SCN1A).
Bangladesh Journal of Medical Science Vol.19(2) 2020 p.315-318
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Sirait, Imelda, Linda Tampubolon, Ance Siallagan, Jagentar Pane, and Tisep Telaumbanua. "The Relationship Between Mother's Knowledge and Handling of Fever Seizures in Children aged 1-5 years in Central Village, Pancur Batu District in 2020." Jurnal Ilmu Keperawatan (Journal of Nursing Science) 9, no. 1 (May 31, 2021): 72–78. http://dx.doi.org/10.21776/ub.jik.2021.009.01.9.
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Febrile convulsion often found in children 3-5 years old. This problem is a seizure that occurs when the body temperature rises and is caused by the extracranium process. This research was to decide the relationship between mother’s knowledge and management of febrile convulsion in children 1-5 years old in the Tengah village of Pancur Batu district 2020. This research is a cross-sectional study. We used to simple random sampling technique with 30 respondents. We used a questionnaire for the instrument. The final results showed that the majority of mother's knowledge regarding the management of febrile seizures was in the good category (86.7%) and the majority of febrile seizure management was in the category (90.0%). The results of chi-square statistical test show there is a relationship between knowledge of the mother with the handling of febrile seizures in children in the Tengah village of Pancur Batu District in 2020 (p value = 0,039). This study is expected to be an alternative for health workers to increase the promotion and prevention of problems related to the first treatment of febrile seizures. A person's knowledge is a factor that can influence a mother to take action, the better the mother's knowledge of diseases or health problems, the better the handling and vice versa, if the mother's knowledge is less, the handling of health problems will be better. Health education to the community will be a means to increase knowledge about handling health problems in the community.
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Laino, Daniela, Elisabetta Mencaroni, and Susanna Esposito. "Management of Pediatric Febrile Seizures." International Journal of Environmental Research and Public Health 15, no. 10 (October 12, 2018): 2232. http://dx.doi.org/10.3390/ijerph15102232.
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Febrile seizures (FS), events associated with a fever in the absence of an intracranial infection, hypoglycaemia, or an acute electrolyte imbalance, occur in children between six months and six years of age. FS are the most common type of convulsions in children. FS can be extremely frightening for parents, even if they are generally harmless for children, making it important to address parental anxiety in the most sensitive manner. The aim of this review was to focus on the management of FS in the pediatric age. An analysis of the literature showed that most children with FS have an excellent prognosis, and few develop long-term health problems. The diagnosis of FS is clinical, and it is important to exclude intracranial infections, in particular after a complex FS. Management consists of symptom control and treating the cause of the fever. Parents and caregivers are often distressed and frightened after a FS occurs and need to be appropriately informed and guided on the management of their child’s fever by healthcare professionals. Due to the inappropriate use of diagnostic tests and treatments, it is extremely important to improve the knowledge of pediatricians and neurologists on FS management and to standardize the diagnostic and therapeutic work-up.
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Shahzad, Moazzam, Muhammad Salman Faisal, Ernie Shippey, Qamar Iqbal, Laila Hashim, Clint Divine, Zahra Mahmoudjafari, et al. "Evolution in Resource Utilization for Unique Toxicities Related to Chimeric Antigen Receptor T Cell Therapy from 2017 to 2020: A Database Review." Blood 138, Supplement 1 (November 5, 2021): 4844. http://dx.doi.org/10.1182/blood-2021-154341.
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Abstract Introduction: Chimeric antigen receptor T cell therapy (CAR-T) is a novel treatment that utilizes T cells by augmenting them using vector viruses to add antigens to target cancer cells. In 2017, FDA approved CD-19 CAR-T for relapsed/refractory diffuse large B-cell lymphoma and acute lymphoblastic leukemia patients ≤ 26yr old. Unique toxicities associated with CAR-T therapy include cytokine release syndrome (CRS) and immune effector cell-related neurotoxicity (ICANS). Lower-grade CRS and ICANS are managed with tocilizumab, an interleukin-6 antagonist, and steroids. Management of higher-grade CRS and ICANS requires intensive care unit (ICU) admission. Our understanding and management of CRS and ICANS continue to evolve. In this analysis, we conducted a retrospective review using the Vizient database® to investigate toxicity incidence and resource utilization among patients admitted for CAR-T therapy between 2017 and 2020. Methods: We used The Vizient® CDB database to analyze admissions for CAR-T infusion for patients over 18 years of age receiving FDA approved CD19 CAR-T axicabtagene ciloleucel (axi-cel) and tisangenlecleucel (tisa-cel) between 2017 to 2020. We compared patients who received CAR-T between October 2017 and March 2018 (group 1) to those who received CAR-T therapy between October 2019 and March 2020 (group 2). Due to the lack of diagnosis code for CRS or ICANS until 2021, surrogates billing codes such as fever, sepsis, dyspnea were used for CRS. In regards to ICANS, we used codes for febrile seizure, febrile convulsions, altered mental status, somnolence, and stupor. In addition, other adverse events such as weakness and nausea were also collected. Results: Eighty-one institutions had performed CAR-T in the period 2017 through 2020. The 2017-2018 period (group 1) included 215 patients, with a median age of 59 (49-68) years, while the CAR-T recipients in 2019-2020 (group 2) had 655 patients with a median age of 62 (52-69) years. Tisa-cel and Axi-cel was administered to 31% (n= 67) and 69% (n= 148) in group 1 and 26% (182) and 74% (n= 517) of group 2 patients respectively. The incidence of sepsis in group 1 was 18% vs. 13% in group 2, with an absolute difference of -5.8% (P value=0.04). Fever and dyspnea were the most common presentations of CRS present in 44.2% and 49% in group 1 and 35% and 28% in group 2, respectively. The incidence of fever decreased by 8.2% (p=0.02) in group 2 compared to group 1. The incidence of hypoxia was 24.7% vs. 20.5%, and the incidence of hypotension was 32.1% and 33.8% in groups 1 and 2, with no statistically significant difference between the two groups (p=0.64 and 0.19). The incidence of neurotoxicity decreased slightly in group 2 compared to group 1, but it was not statistically significant (P= 2723). Overall ICU utilization was 24.7 and 24.6% in both groups (p=0.9). The 30 days mortality in groups 1 and 2 was 6% vs. 3.7%. Tocilizumab utilization decreased by 20%, and dexamethasone or equivalent steroid usage decreased by 70% in group 2 compared to group 1. (Table 1) Conclusions: The incidence of CRS and ICANS among recipients of CAR-T remains high, with up to one-fourth of the patients requiring ICU, which has remained static. However, the general use of tocilizumab and steroids has decreased by 20% and 70%, respectively, possibly due to the implementation of consensus grading and operation protocols that may have increased awareness and judicious early interventions. Figure 1 Figure 1. Disclosures Mahmoudjafari: Incyte: Membership on an entity's Board of Directors or advisory committees; Omeros: Membership on an entity's Board of Directors or advisory committees; GSK: Membership on an entity's Board of Directors or advisory committees.
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Li, Bin, Youjia Wu, Qingjuan He, Hui Zhou, and Jin Cai. "The effect of complicated febrile convulsion on hippocampal function and its antiepileptic treatment significance." Translational Pediatrics 10, no. 2 (February 2021): 394–405. http://dx.doi.org/10.21037/tp-20-458.
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Kanemoto, K., N. Takuji, J. Kawasaki, and I. Kawai. "Characteristics and treatment of temporal lobe epilepsy with a history of complicated febrile convulsion." Journal of Neurology, Neurosurgery & Psychiatry 64, no. 2 (February 1, 1998): 245–48. http://dx.doi.org/10.1136/jnnp.64.2.245.
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Okumura, Akihisa, Yoshiko Ishiguro, Ayako Sofue, Yoshiko Suzuki, Koichi Maruyama, Tetsuo Kubota, Tamiko Negoro, and Kazuyoshi Watanabe. "Treatment and outcome in patients with febrile convulsion associated with epileptiform discharges on electroencephalography." Brain and Development 26, no. 4 (June 2004): 241–44. http://dx.doi.org/10.1016/s0387-7604(03)00161-x.
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Biswas, Rabi, Abu Sayed Munsi, Md Maksudur Rahman, Nasreen Begum, and Rajib Chandra Das. "Clinical Profile of Febrile convulsion among admitted children in a tertiary care hospital at Dhaka city." Northern International Medical College Journal 7, no. 1 (November 16, 2015): 101–4. http://dx.doi.org/10.3329/nimcj.v7i1.25703.
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Background : Febrile convulsion (FC) is the most common type of seizure that occurs in children aged 4-60 months, which is benign and had a good prognosis.Objective : To evaluate the clinical profile and management of hospitalized children with Febrile convulsion.Methodology : This cross sectional study was done in Dhaka Shishu (children) Hospital during July 01, 2013 to June 30, 2014. Total 80 children aged between 4-72 months who were admitted in to Pediatric Medicine department with diagnosis of FC were purposively recruited in the study. Data were collected by a trained physician from history, clinical examination, laboratory findings, treatment and outcome using a structured questionnaire.Results : Among the study children 41(51.3%) were between 6 months to 12 months with a male to female ratio was1.5:1. Forty-nine (61.2%) children had simple seizures, and 16 (20%) of the patients had family history of febrile seizures. In 70 (87.5%) cases the duration of seizure was less than 15 minutes and 75% patients had less than one attack within 24 hours of onset of fever. Upper respiratory tract infection was the most common (31%) cause of fever followed by unclassified in 21 (26%) cases. Complete blood count revealed leukocytosis in 49% cases, CRP raised in 30% cases while CSF study and ultrasonography of brain was normal in 30 cases and 10 cases. We could not perform any investigation to isolate possible causative virus. More than 90% per cent received intravenous broad-spectrum antibiotics and prophylactic anticonvulsant drugs during early days of hospitalization.Conclusion : In this study, Upper respiratory Tract infection was found as common cause of febrile convulsion. Duration of seizure was less than 15 minutes and Leukocytosis, raised CRP was identified and nearly all patients received broad-spectrum antibiotics during hospital stay.Northern International Medical College Journal Vol.7(1) Jul 2015: 101-104
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Ahorlu, Collins Stephen, Ignatius Cheng Ndong, Daniel Okyere, Benedicta A. Mensah, Chuo Ennestine Chu, Juliana Y. Enos, and Benjamin Abuaku. "The Effect of Mass Testing, Treatment and Tracking on the Prevalence of Febrile Illness in Children under 15 in Ghana." Pathogens 11, no. 10 (September 29, 2022): 1118. http://dx.doi.org/10.3390/pathogens11101118.
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Background: Malaria remains a serious threat to children under 15 years of age in sub-Sahara Africa. Mass testing, treatment and tracking (MTTT) of malaria has been reported to reduce parasite load significantly. However, the impact of MTTT on the prevalence of febrile illnesses in children under 15 is not yet clear. This study explores the impact of MTTT complemented by prompt home-based management of malaria on febrile illnesses and their treatment in children under 15 years old. Methods: A cohort of 460 children under 15 years were recruited from the Pakro subdistrict in Ghana during a community-wide implementation of a quarterly MTTT intervention. The MTTT implementation involved testing all household members for malaria using RDTs, and positive cases were treated with Artemisinin-based combination therapy (ACT). Febrile illnesses among this cohort in the two weeks prior to the prevalence survey at baseline and endline were recorded to constitute date for analysis. Results: The prevalence of febrile illnesses, such chills, convulsion, fever, diarrhoea, headache, vomit, cough/rashes or stomachache, etc., were recorded). Asymptomatic parasitaemia prevalence at baseline was 53.3%, which dropped to 44.1% at evaluation. An overall decrease in the parasitaemia prevalence of 33.0% (OR = 0.67, CI = 0.50, 0.89) was observed at evaluation compared to baseline after adjusting for age, ITN use and temperature. A 67% decrease in severe anaemia cases (Hb < 7) was observed at evaluation. Conclusion: Our findings suggest that implementing MTTT complemented by home-based timely management of malaria does not only reduce febrile illnesses and for that matter malaria prevalence, but could also reduce severe anaemia in children under 15 years old.
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Vurucu, Sebahattin, Mehmet Saldir, Bulent Unay, and Ridvan Akin. "Determination of risk factors associated with seizure relapse after antiepileptic drug withdrawal." Open Medicine 5, no. 2 (April 1, 2010): 251–56. http://dx.doi.org/10.2478/s11536-009-0049-y.
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AbstractThere is no consensus regarding the time of antiepileptic drug withdrawal and the relevant risk factors for seizure relapse. In this study, we aimed to determine the seizure relapse rates and the associated risk factors for seizure relapse in childhood epilepsy. Two-hundred sixty-six epileptic patients who discontinued the antiepileptic drug therapy after a seizure-free period of at least two years, were enrolled into the study. The data of the patients regarding sex, febrile convulsion history, family history, age at onset, type of epilepsy, total number of seizures and antiepileptic drugs, seizures during treatment, mental status, first and last electroencephalography, brain imaging findings, etiological factors and seizure relapse in the first two years after antiepileptic drug withdrawal were obtained from the patients’ files. Univariate logistic regression analysis was performed for each variable. The variables which were found to be statistically significant in univariate analysis, were included in multivariate logistic regression analysis. The overall seizure relapse rate after antiepileptic drug withdrawal was 19.2%. There were no significant differences for seizure relapse rate after antiepileptic drug withdrawal between patient groups with respect to sex, family history, type of epilepsy, febrile convulsion history, seizures before treatment, first electroencephalography findings, brain imaging findings and etiology. However, there were statistically significant differences for seizure relapse rate among patient groups concerning age at onset of epilepsy, new seizure during treatment, the total number of antiepileptic drugs, mental status, and last electroencephalography findings. We imply that the clinical status of the patients should be considered before the cessation of drug therapy rather than the etiological factors or laboratory findings.
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A, Ibanga A., Ochigbo S. O, and Osong A. O. "The Severity of Ophthalmic Damage Following Plantain Sap Used in the Treatment of Febrile Convulsion (A Case Report)." Scholars Journal of Medical Case Reports 9, no. 10 (October 14, 2022): 994–96. http://dx.doi.org/10.36347/sjmcr.2021.v09i10.018.
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In the course of both conventional (orthodox) and non-orthodox (trado - spiritual, etc) health care service delivery we encounter patients that may present with conditions that require eye care intervention primarily or with eye ailments alongside other systemic ailments. The initial interventional measure may be deficient and sometimes results in severe ocular morbidity. This case report is the instillation of substance (sap from plantain stem) into the eyes of a one-month old male child by a non-orthodox health care provider in the treatment of febrile seizure with the aim to subside twitching of the eye lid that usually accompany other generalized tonic clonic activities in febrile seizures which the child presented with to the spiritual practitioner. This resulted in severe ocular chemical injury as presented here with bilateral symblepharon and corneal ulceration. Intervention by rodding with copious antibiotic ointment under topical anaesthetic reversed the symblepharon while institution of topical vitamin C fortified tear substitute, cycloplegic and antibiotics achieved positive results with resolution of the corneal ulcer. The case report identifies one of such of so many conditions where the larger health care service primary intervention interferes negatively with proper eye care service intervention, hence the need for universal health services where eye care service needs to be properly integrated into the larger health care service including the non-orthodox health care providers by way of health education and awareness.
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A, Ibanga A., Ochigbo S. O, and Osong A. O. "The Severity of Ophthalmic Damage Following Plantain Sap Used in the Treatment of Febrile Convulsion (A Case Report)." Scholars Journal of Medical Case Reports 9, no. 10 (October 14, 2022): 994–96. http://dx.doi.org/10.36347/sjmcr.2021.v09i10.018.
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In the course of both conventional (orthodox) and non-orthodox (trado - spiritual, etc) health care service delivery we encounter patients that may present with conditions that require eye care intervention primarily or with eye ailments alongside other systemic ailments. The initial interventional measure may be deficient and sometimes results in severe ocular morbidity. This case report is the instillation of substance (sap from plantain stem) into the eyes of a one-month old male child by a non-orthodox health care provider in the treatment of febrile seizure with the aim to subside twitching of the eye lid that usually accompany other generalized tonic clonic activities in febrile seizures which the child presented with to the spiritual practitioner. This resulted in severe ocular chemical injury as presented here with bilateral symblepharon and corneal ulceration. Intervention by rodding with copious antibiotic ointment under topical anaesthetic reversed the symblepharon while institution of topical vitamin C fortified tear substitute, cycloplegic and antibiotics achieved positive results with resolution of the corneal ulcer. The case report identifies one of such of so many conditions where the larger health care service primary intervention interferes negatively with proper eye care service intervention, hence the need for universal health services where eye care service needs to be properly integrated into the larger health care service including the non-orthodox health care providers by way of health education and awareness.
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Parvin, Jobaida, Narayan Chandra Saha, Dipa Saha, Sk Azimul Huque, Ariful Islam, and Yamin Shahriar Chowdhury. "Immediate Treatment Outcome of Convulsive Status Epilepticus Following a Specific Management Protocol." Journal of National Institute of Neurosciences Bangladesh 5, no. 1 (July 12, 2019): 33–37. http://dx.doi.org/10.3329/jninb.v5i1.42166.
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Background: Status epilepticus (SE) is a medical and neurologic emergency. Rapid and aggressive treatmentis required to prevent neuronal damage, systemic complications and death. Standardized treatment guidelines may improve the quality of emergency managementof SE.
Objectives: The objective of the present study was to assess under lying causes of seizure and the immediate outcome of treatment following the specific proposed management protocol care.
Methodology: This cross-sectional study was undertaken on 94 consecutive cases admitted inPediatrics department of Dhaka Medical College Hospital, Dhaka diagnosed as convulsive status epilepticus, age<15 years from September, 2012 – February, 2013. Cases were treated with specific institutional protocol. Under lying causes, outcome of the treatment and side effects of the drugs used were analyzed.
Results: Among 94 cases, most of the patients belonged to 6 months - 5 years (73.34%), M: F was1.17:1. The leading presenting features were fever (75.53%), headache (36.17%), meningeal irritation (22.34%).Major causes of convulsive status epilepticus were febrile convulsion (42.6%), meningitis (22.3%), and epilepsy (21.3%), more than two-third (71%) had GTCS, 29% had focal seizure. Most of them presented within 6 hours of convulsion and nearly half of the patient responded to per-rectal diazepam with complete recovery and without any residual problems. A very few cases developed immediate or late behavioral problems or residual neurological deficit like hemiplegiaand epilepsy.
Conclusion: Establishing causative factors and early intervention with specific treatment protocol can make rapid seizure control with better outcome.
Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 33-37
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Wang, Tongfei A., Chao Chen, Fen Huang, Shengjie Feng, Jason Tien, João M. Braz, Allan I. Basbaum, Yuh Nung Jan, and Lily Yeh Jan. "TMEM16C is involved in thermoregulation and protects rodent pups from febrile seizures." Proceedings of the National Academy of Sciences 118, no. 20 (May 10, 2021): e2023342118. http://dx.doi.org/10.1073/pnas.2023342118.
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Febrile seizures (FSs) are the most common convulsion in infancy and childhood. Considering the limitations of current treatments, it is important to examine the mechanistic cause of FSs. Prompted by a genome-wide association study identifying TMEM16C (also known as ANO3) as a risk factor of FSs, we showed previously that loss of TMEM16C function causes hippocampal neuronal hyperexcitability [Feenstra et al., Nat. Genet. 46, 1274–1282 (2014)]. Our previous study further revealed a reduction in the number of warm-sensitive neurons that increase their action potential firing rate with rising temperature of the brain region harboring these hypothalamic neurons. Whereas central neuronal hyperexcitability has been implicated in FSs, it is unclear whether the maximal temperature reached during fever or the rate of body temperature rise affects FSs. Here we report that mutant rodent pups with TMEM16C eliminated from all or a subset of their central neurons serve as FS models with deficient thermoregulation. Tmem16c knockout (KO) rat pups at postnatal day 10 (P10) are more susceptible to hyperthermia-induced seizures. Moreover, they display a more rapid rise of body temperature upon heat exposure. In addition, conditional knockout (cKO) mouse pups (P11) with TMEM16C deletion from the brain display greater susceptibility of hyperthermia-induced seizures as well as deficiency in thermoregulation. We also found similar phenotypes in P11 cKO mouse pups with TMEM16C deletion from Ptgds-expressing cells, including temperature-sensitive neurons in the preoptic area (POA) of the anterior hypothalamus, the brain region that controls body temperature. These findings suggest that homeostatic thermoregulation plays an important role in FSs.
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Biswas, Rupa, Kaushambi Basu, Ishita Tripathi, and Sunetra Kaviraj Roy. "A study on etiology, clinical profile and outcome of acute febrile encephalopathy in children: A prospective study at a tertiary care center of Eastern India." Asian Journal of Medical Sciences 12, no. 4 (April 1, 2021): 86–91. http://dx.doi.org/10.3126/ajms.v12i4.35153.
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Background: Acute febrile encephalopathy (AFE) is defined as fever associated with acute alteration of consciousness, with or without seizure, motor and/ or sensory deficit and total duration of illness one week or less. It is associated with significant morbidity and mortality in children. Various etiologies have been implicated in its causation and differ as per geographical. Efforts to promptly identify the underlying etiology and institute appropriate treatment early and adequately should be our goal so as to avoid any long-term sequelae and death.
Aims and Objectives: To evaluate the clinical profile and aetiology of children presenting with fever and altered sensorium and to assess the predictors of morbidity & mortality related to Acute Febrile Encephalopathy.
Materials and Methods: In this prospective, hospital-based study, a total of 282 children, between 1month to 12 years, presenting to the department of Pediatric Medicine, Calcutta National Medical College, Kolkata, West Bengal, India with fever and altered sensorium were clinically evaluated and investigated. Each patient was examined for vital signs, detailed systemic examination with focus on neurological examination. The etiology of AFE was evaluated based on detailed history, a meticulous clinical examination and relevant investigations.
Results: The incidence of AFE was 5% of the total hospital admissions. Demographic profile showed 166 (58.8%) males, 116 (41.2%) females and 48% of the study population less than 5 years of age. The most important presenting complaints apart from fever and altered sensorium, were convulsion and vomiting. Raised Intracranial tension (58%), low GCS (58%) and shock (48%) were commonest presenting signs. CNS infections were the most common cause of AFE encountered. Low GCS, refractory seizures, multi-organ failure respiratory failure were significantly associated with death (p<0.005).
Conclusions: CNS infections are the leading cause of febrile encephalopathy. Toxic- metabolic and unknown etiologies contributed maximum to the mortality. Low GCS, shock, refractory seizures, multi-organ failure and respiratory failure are associated with higher risk of mortality. Most of the morbidities were observed in auto-immune encephalitis and ADEM and as most of them were curable, early institution of appropriate treatment will decrease morbidity.
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He, Wei. "Comparative study on the efficacy and safety of low-dose sodium valproate vs. diazepam in the prevention and treatment of pediatric febrile convulsion." Translational Pediatrics 9, no. 6 (December 2020): 768–74. http://dx.doi.org/10.21037/tp-20-260.
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He, Wei. "Comparative study on the efficacy and safety of low-dose sodium valproate vs. diazepam in the prevention and treatment of pediatric febrile convulsion." Translational Pediatrics 9, no. 6 (December 2020): 768–74. http://dx.doi.org/10.21037/tp-20-1789.
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Yunisova, Gulshan, Zeynep Tufekcioglu, Okan Dogu, Başar Bilgic, Hakan Kaleagasi, Sukriye Akca Kalem, Ebba Lohmann, Hakan I. Gurvit, Murat Emre, and Hasmet A. Hanagasi. "Patients with Lately Diagnosed Cerebrotendinous Xanthomatosis." Neurodegenerative Diseases 19, no. 5-6 (2019): 218–24. http://dx.doi.org/10.1159/000506770.
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Objectives: Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive inborn lipid storage disorder due to various pathogenic mutations in the CYP27A1 gene. Although the symptoms begin commonly in infancy, CTX diagnosis is often delayed. In this study, we report 7 Turkish CTX patients who had a delayed diagnosis despite early clinical signs and belonged to 6 unrelated families. Methods: We have retrospectively evaluated clinical, laboratory, imaging, and genetic findings of CTX patients, which were collected from 2 centers specialized in movement disorders: the Department of Neurology, Faculty of Medicine, Istanbul University, and the Department of Neurology, Faculty of Medicine, Mersin University. Results: All patients were diagnosed with CTX after neurological symptom development, and their mean age at diagnosis was 38.7 ± 9.6 years, despite a mean onset age of 12.4 ± 10.6 years. The mean follow-up period was 28 months (range: 3–60 months). The most common initial clinical abnormalities in our cohort were unexplained chronic diarrhea (42%), febrile convulsion (42%), juvenile cataract (85%), childhood depression and autism (14%), parkinsonism (14%), and intellectual disability (100%). The most prominent neurological findings were the pyramidal-cerebellar syndrome (85%) and extrapyramidal signs (42%). All patients were genetically confirmed. Serum cholestanol levels were elevated in all patients and decreased after chenodeoxycholic acid (CDCA) treatment in 6 patients. Conclusion: This cohort is the largest CTX case series in Turkey. All cases showed improvement in gastrointestinal symptoms as a response to CDCA treatment and stabilization on neurological symptoms, i.e., no further progression of neurological abnormalities were noted during this treatment. Therefore, early diagnosis and treatment is crucial in preventing clinical deterioration.
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Morisawa, Y., Y. Ohya, T. Katsunuma, T. Ishii, H. Watanabe, T. Suda, H. Kawahara, H. Matsumota, Hiroshi Wakiguchi, and A. Akasawa. "The influence of long-term treatment with histamine H1 receptor antagonists and theophylline on the incidence of febrile convulsion in children with atopic dermatitis and/or asthma." Journal of Allergy and Clinical Immunology 109, no. 1 (January 2002): S120. http://dx.doi.org/10.1016/s0091-6749(02)81477-4.
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Akoğlu, Handan A., Muhammet Bulut, Dilek K. Alemdar, Serdar Aslan, Kıvanç Çelikkalkan, Serkan Tursun, Emine Tekin, Hatice Baba, and Selçuk Takır. "Evaluation of Childhood COVID-19 Cases: A Retrospective Analysis." Journal of Pediatric Infectious Diseases 16, no. 03 (February 25, 2021): 091–98. http://dx.doi.org/10.1055/s-0041-1723957.
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Abstract Objective This study aims to evaluate the demographic, epidemiological, and clinical features of novel coronavirus disease 2019 (COVID-19) cases aged between 0 and 18 years. Methods The demographic characteristics of the patients, admission symptoms, contact and travel histories, clinical onset duration, symptoms, treatments, laboratory findings, radiological images, and polymerase chain reaction (PCR) negation times were evaluated in a retrospective manner. Thirty-eight children (19 boys and 19 girls) were included in the study. Results The mean age of the patients was 10.36 ± 5.59 years. The average admission times of the patients after the onset of the symptoms was determined as 1.84 ± 2.02 days. Thirteen (34.2%) patients were observed as asymptomatic. The most common identified symptoms were fever, cough, and fatigue (55.2, 34.2, and 13.2%, respectively). Febrile convulsions, myalgia, dizziness, and diarrhea were the least common symptoms. Also, 25-hydroxyvitamin D3 (vitamin D3) levels were low and aspartate aminotransferase (AST) values were higher in the moderate group than the mild group and the relationships were statistically significant (p = 0.044and 0.027). Ferritin levels of the patients with ground glass opacity (GGO) were found statistically and significantly higher than the patients without GGO (p = 0,031). There was more than one lobe and segment involvement in five patients, the average number of affected lobes and segments was 3.8 and 8.8, respectively. High-resolution computed tomography of the 24 patients showed that; GGO in five (20.8%), consolidation + GGO (mixed) in three (12.5%), consolidation (alone) in one, subpleural linear opacities in three (12.5%), and pavement stone opacities in one (4.2%) patient. COVID-19, which is seen less frequently in children, may pose a risk in infants and young children. Conclusion Especially high ferritin levels may present with lung involvement and low vitamin D levels may worsen the aggravation of the lung involvement. There is a great need for further research on this subject.
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Wijaya, Sapondra, and Bambang Soewito. "Pelatihan Penatalaksanaan Prehospital Henti Janting Dan Anak Demam Dengan Konsep Safe Community Di Kota Lubuklinggau." JURNAL KREATIVITAS PENGABDIAN KEPADA MASYARAKAT (PKM) 4, no. 5 (October 1, 2021): 1124–31. http://dx.doi.org/10.33024/jkpm.v4i5.4248.
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ABSTRAK Kasus kegawatan medis dapat terjadi dimana dan kapan saja, salah satunya adalah henti jantung dan demam anak. Akan sangat berbahaya kejadian yang terjadi di lingkungan masyarakat yang tidak ada orang yang mampu memberikan pertolongan pertama, ataupun tidak tahu kemana akan mencari pertolongan. Kesalahan memberikan pertolongan bisa membuat pasien menjadi lebih menderita dan meninggalkan kecacatan. Keadaan diatas memerlukan pertolongan yang baik dan segera sebelum pasien dibawa ke rumah sakit untuk perawatan definitif. Permasalahan muncul karena tidak banyak orang awam di yang bisa memberikan pertolongan pertama pada kejadian tersebut dan ketidaktahuan akan sistem pengaduan kasus tersebut. Kegiatan ini dilaksanakan dengan metode demonstrasi dan praktik agar partisipan memiliki pengetahuan dan keterampilan pertolongan pada henti jantung dan demam pada anak. Selain itu butuh pembuatan sebuah sistem sederhana berbasis komunitas sebagai alur awal pertolongan pasien, dengan sistem ini masyarakat mengetahui kemana mereka harus melapor. Semua rangkaian kegiatan tersebut dengan tujuan membentuk sebuah komunitas yang aman yang disebut “Safe Community”. Dari pelaksanaan kedua pelatihan tersebut di atas, terdapat peningkatan pengetahuan dan keterampilan masyarakat dalam memberikan pertolongan henti jantung dan demam anak yaitu sebesar rata-rata 23 poin dalam skala 100. Kata Kunci: Henti Jantung, Kejang Demam, Safe Community ABSTRACT Medical emergency cases can occur anywhere and anytime, one of which is cardiac arrest and childhood fever. It would be very dangerous to happen in a community where no one is able to provide first aid, or does not know where to go for help. Mistakes in providing help can make patients suffer more and leave disabilities. The above conditions require good and immediate assistance before the patient is admitted to the hospital for definitive treatment. The problem arose because there were not many ordinary people who could provide first aid to the incident and they were ignorant of the complaint system for the case. This activity is carried out with demonstration and practical methods so that participants have the knowledge and skills to help with cardiac arrest and fever in children. In addition, it is necessary to create a simple community-based system as the initial flow of patient assistance, with this system the community knows where they have to report. All of these series of activities are aimed at forming a safe community called "Safe Community". From the implementation of the two pieces of training above, there is an increase in the knowledge and skills of the community in providing assistance for cardiac arrest and child fever, which is an average of 23 points on a scale of 100. Keywords: Cardiac Arrest, Febrile Convulsion, Safe Community
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Kuemmerle-Deschner, J. B., J. Henes, B. Kortus-Goetze, T. Kallinich, P. Oommen, J. Rech, T. Krickau, et al. "POS1374 LONG-TERM SAFETY OF CANAKINUMAB IN PATIENTS WITH AUTOINFLAMMATORY DISEASES - INTERIM ANALYSIS OF THE RELIANCE REGISTRY." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1026–27. http://dx.doi.org/10.1136/annrheumdis-2022-eular.4903.
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BackgroundAutoinflammatory diseases (AID) are characterized by severe systemic and organ inflammation as well as high burden of disease for patients and their families. Treatment with the monoclonal antibody canakinumab (CAN), an interleukin-1β inhibitor, has been proven to be safe and effective in clinical trials and real-life.ObjectivesThe present study explores the long-term efficacy and safety of CAN in routine clinical practice conditions in pediatric (age ≥2 years) and adult patients with CAPS (cryopyrin-associated periodic syndromes), FMF (familial Mediterranean fever), TRAPS (tumor necrosis factor receptor-associated periodic syndrome) and HIDS/MKD (hyperimmunoglobulinemia D syndrome/mevalonate kinase deficiency).MethodsRELIANCE is a prospective, non-interventional, observational study based in Germany. Patients with clinically confirmed diagnoses of AID routinely receiving CAN are enrolled. Besides efficacy parameters regarding disease activity and remission, safety parameters were recorded at baseline and assessed at 6-monthly intervals.ResultsHere, we present the interim analysis of patients with AID (N=199) enrolled in the RELIANCE Registry between October 2017 and December 2021. Mean age in this cohort was 24.4 years (2–79 years) and the proportion of female patients was 53% (N=104). At baseline, median duration of prior CAN treatment was 2 years (0–12 years).A total of 123 patients (62%) experienced any AE (N=653) among which nasopharyngitis, increase of inflammatory markers and pyrexia were the most frequent AE with incidence rates per 100 patient years (IR) of 8.3, 6.2, and 6.2, respectively.29 patients (15%) were affected by severe AE (SAE, total number N=90) including 11 patients (6%) with SAE suspected to be drug-related (SADR; total number N=30) with IR from 0.2 to 0.7 (Table 1). Overall, 16 AE comprised upper respiratory tract infections (URI). One death (COVID-19, not related) and one malignancy (skin papilloma, not related) were reported. No vertigo and no hypersensitivity reactions were observed. N=10 (IR 2.36) vaccination reactions were reported (no SAE).Table 1.Overview of the CAN safety data of the RELIANCE study across all study indications (N=199 patients).Type of eventNumber of eventsIR‡AE total653154.43AE non-serious563133.15AE, non-serious, not related31774.97AE, URI163.78AE, non-serious adverse drug reaction24658.18SAE, total9021.28SAE, not related6014.19SADR#, total307.09#Abdominal pain; Alport’s syndrome, appendicitis, arthralgia, blister, cardiovascular disorder, chest pain, circulatory collapse, dehydration, diplopia, dyspnoea, erythema, febrile convulsion, gastroenteritis, glomerulonephritis, Haemophilus test positive, myalgia, oedema, pneumonia, premature delivery, skin discoloration, tachycardia, tonsillitis bacterial, tonsillitis streptococcal, vision blurred (each n=1 event, IR 0.24‡), tonsillectomy (2 events, IR 0.47‡), pyrexia (3 events, IR 0.71‡), not yet coded (hospital admission due to exsiccosis upon gastroenteritis, 1 event, IR 0.35‡)‡IR, incidence rate per 100 patient years; AE, adverse event; URI, upper respiratory tract infection; SAE, severe adverse event, SADR, severe adverse drug reactionIncidence rate = number of events * 36,525 / sum of observation days (=154,442)ConclusionThe interim data from the RELIANCE study, the longest running real-life canakinumab registry, confirm safety of long-term canakinumab treatment across the entire study population. A trend for dose-related increase of SAE/SADR requires continuous close monitoring and awareness in patient groups (children, severe phenotypes, certain genotypes) requiring greater than standard dose treatment regimens.Disclosure of InterestsJ. B. Kuemmerle-Deschner Consultant of: Novartis, AbbVie, Sobi, Grant/research support from: Novartis, AbbVie, Sobi, Jörg Henes Consultant of: Novartis, AbbVie, Sobi, Roche, Janssen, Boehringer-Ingelheim, Grant/research support from: Novartis, Roche, Birgit Kortus-Goetze Consultant of: Novartis, Tilmann Kallinich Consultant of: Sobi, Novartis, Roche, Grant/research support from: Novartis, Prasad Oommen Grant/research support from: Novartis, Jürgen Rech Speakers bureau: Abbvie, Biogen, BMS, Chugai, GSK, Janssen, Lilly, MSD; Mylan, Novartis, Roche, Sanofi, Sobi, UCB, Consultant of: Abbvie, Biogen, BMS, Chugai, GSK, Janssen, Lilly, MSD, Mylan, Novartis, Roche, Sanofi, Sobi, UCB, Grant/research support from: Novartis, Sobi, Tobias Krickau Speakers bureau: Novartis, Consultant of: Novartis, Grant/research support from: Novartis, Frank Weller-Heinemann: None declared, Gerd Horneff Speakers bureau: AbbVie, Bayer, Chugai, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Grant/research support from: AbbVie, Chugai, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Ales Janda: None declared, Ivan Foeldvari Consultant of: Novartis, Hexal, Medac, Pfizer, Catharina Schuetz: None declared, Frank Dressler Consultant of: Abbvie, Mylan, Novartis, Pfizer, Grant/research support from: Novartis, Michael Borte Grant/research support from: Pfizer, Shire, Markus Hufnagel Consultant of: Novartis and SOBI, Florian Meier Speakers bureau: Novartis, Michael Fiene: None declared, Julia Weber-Arden Employee of: Novartis, Norbert Blank Consultant of: Novartis, Sobi, Lilly, Pfizer, Abbvie, BMS, MSD, Actelion, UCB, Boehringer-Ingelheim, Roche, Grant/research support from: Novartis, Sobi