Febrile convulsion during the acute phase of Kawasaki disease

Abstract

The incidence of febrile convulsions in the acute phase of Kawasaki disease might be extremely low, confirming the results of previous reports. Kawasaki disease is characterized by systemic vasculitis and is sometimes complicated by intracranial vasculitis. The incidence of electroencephalographic abnormalities and pleocytosis in the cerebrospinal fluid is higher in patients with Kawasaki disease. However, the reason why febrile convulsions did not occur in the acute phase of Kawasaki disease remains unknown, despite the presence of central nervous system involvement.

Low incidence of febrile convulsion during the acute phase of Kawasaki disease in Japan

“…On meta-analysis of our series and these reports, the incidence was 2/ 1089 (0.18%, 95% CI: 0.02%-0.66%). When limited to patients £ 5 years of age, a predominant period for FC, this figure was somewhat higher; however, the lack of age distribution in previous studies [3,5] precluded precise determination. In any case, the incidence was unexpectedly low, compared to an epidemiological finding on the FC prevalence (8.3%) at 3 years of age in Japan [4].…”

“…We reviewed the English literature and found three reports on this issue [2,3,5], all of which were conducted in Japan. Patient number in each study was 155 [2], 540 [3], and 177 [5], and there has been only one patient, a 5-year-old boy [2], with FC among them.…”

“…Patient number in each study was 155 [2], 540 [3], and 177 [5], and there has been only one patient, a 5-year-old boy [2], with FC among them. On meta-analysis of our series and these reports, the incidence was 2/ 1089 (0.18%, 95% CI: 0.02%-0.66%).…”

Kawasaki disease complicated by mild encephalopathy with a reversible splenial lesion (MERS)

“…The most important complication of KD is coronary arterial aneurysms (in 15-25% of untreated children), which may cause ischemic heart disease and sudden death [1,2]. Irritability, lethargy, transient unilateral facial nerve palsy are sometimes observed, and pleocytosis in the cerebrospinal fluid (CSF) is found in around 40% [1][2][3][4], however, febrile convulsions and acute encephalopathy are extremely rare [5][6][7].…”

Involvement of Nervous System in Kawasaki Disease

“…The underlying reason for the absence of febrile convulsions in the acute phase of Kawasaki disease, despite the presence of CNS involvement, remains unknown. 65 It is noteworthy that MRI of the brain of some children with Kawasaki disease and seizures revealed bilateral high-signal lesions in T2 sequence. These lesions were possibly triggered by the increased permeability of brain microvessels, attributable to systemic vasculitis.…”