შეჯამება
განსაზღვრება
病史和体格检查
关键诊断因素
- febrile illness
- seizure
其他诊断因素
- normal postictal exam
危险因素
- temperature elevation
- young age
- male sex
- family history of febrile seizures
- viral or bacterial infection outside the central nervous system
- vaccinations
- prenatal exposure to nicotine
- iron deficiency
- complications of pregnancy, labor, and delivery
诊断性检查
首要检查
- diagnosis is clinical
Tests to avoid
- head CT
需考虑的检查
- lumbar puncture
- viral studies
- blood culture
- EEG
- brain MRI
- serum sodium
- CBC
- capillary blood glucose
- serum glucose
- iron studies
治疗流程
febrile status epilepticus
first simple febrile seizure
first complex seizure
febrile illness with prior history of simple seizure or 1 complex seizure
history of 2 or more complex febrile seizures with ineffective diazepam treatment
撰稿人
作者
Damian Roland, BMedSci, MBBS, FRCPCH, PhD
Honorary Professor and Consultant in Paediatric Emergency Medicine
Paediatric Emergency Medicine Leicester Academic (PEMLA) Group
Children’s Emergency Department
Leicester Royal Infirmary
Leicester
UK
利益声明
DR declares that he is a previous member of the National Institute for Health and Care Excellence Feverish Illness in Children Guideline Group.
鸣谢
Prof Damian Roland would like to gratefully acknowledge Dr Leena Mewasingh, Dr Frances Morrison, Dr John J. Millichap and Dr J. Gordon Millichap, previous contributors to this topic. LM has received funding from drug companies (e.g., Eisai) to attend medical conferences and been invited to an educational symposium (Novartis, LivaNova). FM declares that she has no competing interests. JJM serves as an Associate Editor of Neurology and serves on the editorial board of Pediatric Neurology Briefs; volunteers on the medical advisory board of The Jack Pribaz Foundation (KCNQ2.org); received speaker honoraria from Invitae; received royalties for online monographs from Up-To-Date; served on the scientific advisory board for Mallinckrodt; is principal investigator for a clinical trial funded by UCB Pharma; and is the principal investigator for research grants from Citizens United for Research in Epilepsy and the Thrasher Research Fund. JJM is an author of a number of references cited in this topic. JGM is an author of a number of references cited in this topic.
同行评议者
Robert S. Rust, Jr., MA, MD
Professor
Department of Neurology
University of Virginia Health System
Charlottesville
VA
利益声明
RSR declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
American Academy of Pediatrics: Subcommittee on Febrile Seizures. Clinical practice guideline: neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011 Feb;127(2):389-94.全文 摘要
American Academy of Pediatrics. Febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics. 2008 Jun;121(6):1281-6.全文 摘要
Millichap JG, Millichap JJ. Role of viral infections in the etiology of febrile seizures. Pediatr Neurol. 2006 Sep;35(3):165-72. 摘要
Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr. 2008 Jan;167(1):17-27. 摘要
Graves RC, Oehler K, Tingle LE. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician. 2012 Jan 15;85(2):149-53.全文 摘要
Capovilla G, Mastrangelo M, Romeo A, et al. Recommendations for the management of "febrile seizures": Ad Hoc Task Force of LICE Guidelines Commission. Epilepsia. 2009 Jan; 50(1 suppl):S2-6.全文 摘要
Natsume J, Hamano SI, Iyoda K, et al. New guidelines for management of febrile seizures in Japan. Brain Dev. 2017 Jan;39(1):2-9. 摘要
Nordli DR Jr. Idiopathic generalized epilepsies recognized by the International League Against Epilepsy. Epilepsia. 2005 Nov 18;46(9 suppl):48-56.全文 摘要
Wilmshurst JM, Gaillard WD, Vinayan KP, et al. Summary of recommendations for the management of infantile seizures: task force report for the ILAE Commission of Pediatrics. Epilepsia. 2015 Aug;56(8):1185-97.全文 摘要
Dunlop S, Taitz J. Retrospective review of the management of simple febrile convulsions at a tertiary paediatric institution. J Paediatr Child Health. 2005 Dec;41(12):647-51. 摘要
Kimia AA, Bachur RG, Torres A, et al. Febrile seizures: emergency medicine perspective. Curr Opin Pediatr. 2015 Jun;27(3):292-7. 摘要
Rosenbloom E, Finkelstein Y, Adams-Webber T, et al. Do antipyretics prevent the recurrence of febrile seizures in children? A systematic review of randomized controlled trials and meta-analysis. Eur J Paediatr Neurol. 2013 Nov;17(6):585-8. 摘要
Offringa M, Newton R, Nevitt SJ, et al. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2021 Jun 16;(6):CD003031.全文 摘要
Baumann RJ, Duffner PK; American Academy of Pediatrics. Treatment of children with simple febrile seizures: the AAP practice parameter. Pediatr Neurol. 2000 Jul;23(1):11-7. 摘要
Whelan H, Harmelink M, Chou E, et al. Complex febrile seizures: a systematic review. Dis Mon. 2017 Jan;63(1):5-23.全文 摘要
Shinnar S, Glauser TA. Febrile seizures. J Child Neurol. 2002 Jan;17(1 suppl):S44-52. 摘要
Camfield P, Camfield C. Febrile seizures and genetic epilepsy with febrile seizures plus (GEFS+). Epileptic Disord. 2015 Jun;17(2):124-33. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Acute bacterial meningitis
- Viral meningitis
- Viral encephalitis
更多 鉴别诊断指南
- ACR appropriateness criteria: seizures - child
- Summary of recommendations for the management of infantile seizures: task force report for the ILAE Commission of Pediatrics
更多 指南患者教育信息
Febrile seizures
更多 患者教育信息Videos
Diagnostic lumbar puncture in adults: animated demonstration
Venepuncture and phlebotomy: animated demonstration
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