Neurological, Electroencephalographic, and Virological Findings in Febrile Children

Wallace, Sheila J.; Zealley, Helen

doi:10.1136/adc.45.243.611

Cited by 53 publications

(29 citation statements)

References 29 publications

(21 reference statements)

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“…The study has shown a viral aetiology in a higher proportion of patients than others have reported (Wallace and Zealley, 1970;Familusi et al, 1972;Stokes et al, 1977), probably because several methods of viral diagnosis were used. Tissue culture from fresh specimens gave the highest number of positive results, and additional viruses were detected by electron microscopical examination and inoculation of suckling mice.…”

Section: Discussionmentioning

confidence: 59%

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Role of viruses in febrile convulsions.

Lewis¹,

Parry²,

Parry³

et al. 1979

Archives of Disease in Childhood

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SUMMARY A disseminated viral illness was demonstrated by isolating a virus from the CSF, blood, or urine in 27% of 73 children who were admitted to hospital after a first febrile convulsion However, a viral aetiology could be implicated for 86% of the children after combining results of tissue culture, electron microscopy, mouse inoculation, complement fixation tests, and interferon assay. Parallel bacterial cultures showed a possible pathogen in 29 % of children, but in only 4 % was the pathogen isolated from the CSF, blood, or urine. No correlation was found between the nature of the pathogen (or evidence of its dissemination) and the severity of the convulsion, degree of fever, CSF protein, CSF white cells, or the WBC. The results suggest that a febrile convulsion could be a response to invasion of the blood stream or central nervous system by a micro-organism which is usually a virus. Invasion may be of such brief duration that successful isolation of the virus from the blood, CSF, or urine is not more commonly achieved.

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Section: Discussionmentioning

confidence: 59%

“…Most other reports of the viruses identified in association with febrile convulsions have been limited to isolates from the throat or faeces or to serological tests (Wallace and Zealley, 1970;Stokes et al, 1977). The aim of this study was to establish a viral diagnosis and to find viruses in the CSF, blood, or urine immediately after the convulsion.…”

mentioning

confidence: 99%

Role of viruses in febrile convulsions.

Lewis¹,

Parry²,

Parry³

et al. 1979

Archives of Disease in Childhood

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“…1,3,36 Por outro lado, não há consenso entre os autores, quanto à contribuição do eletrencefalograma (EEG) na avaliação inicial e no seguimento de crianças com CF e, também, quanto ao valor como exame preditivo do risco de desenvolvimento de CNF e de epilepsia. 11,19,23,35,36 O achado de atividade epileptiforme (AE) no EEG varia de 2 a 86% das crianças com CF. 24,30 Esta grande diversidade pode ser justificada pelos critérios utilizados para a seleção dos casos, faixa etária analisada, período decorrido entre a CF e o EEG, pelo tempo de seguimento dos casos ou, ainda, outras peculiaridades da população estudada.…”

Section: Introductionunclassified

Crise febril: correlação clínico-eletrencefalográfica em 1162 crianças

Fonseca

2007

J. epilepsy clin. neurophysiol.

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RESUMOIntrodução: Crise febril (CF) é comum, e ocorre em aproximadamente 2 a 5% das crianças até 5 anos de idade. Objetivo e Métodos: Avaliar a relação entre aspectos clínicos e ocorrência de atividade epileptiforme (AE) no eletrencefalograma (EEG) em crianças com CF e, naquelas em que houve seguimento, observar, também, o aparecimento de crises epilépticas não febris (CNF). Resultados: Foram avaliadas 1162 crianças de 4 meses a 5 anos de idade. Houve predomínio de CF simples (82,4%) e de episódio único (62,0%). Houve maior recorrência de CF quando a primeira crise ocorreu antes dos 12 meses de idade ou quando era complexa. AE foi encontrada em porcentagem crescente com a idade da criança; em 3% dos pacientes até os dois anos de idade e 33% após os 4 anos. Pontas evocadas pela percussão de pés ou mãos (PE) ocorreu em 3,4% dos casos. CNF foi relatada em 38 (9,5%) crianças. Não houve correlação estatisticamente significativa entre o tipo e número de CF, idade de ocorrência da primeira CF, presença de AE e de PE no EEG e a ocorrência ou o tipo de CNF, no seguimento. Discussão: Há aspectos ainda controversos na literatura, como o prognóstico em relação ao desenvolvimento de epilepsia e o eventual efeito de AE persistente quanto à cognição e comportamento nas crianças que apresentam CF, a exigir pesquisas prospectivas longitudinais.Unitermos: crise febril, atividade epileptiforme, eletrencefalograma, crise não febril. ABSTRACT Febrile seizures: clinical-electroencephalographic correlation in 1162 childrenIntroduction: Febrile seizures (FS) occur in about 2-5% of the children from the age of 6 months do 5 years of age. Objective: The aim of this study is to analyze clinical and EEG aspects of children with febrile seizures. Methods: We retrospectively studied 1162 children (age range: 4 months to 5 years) with FS. The relationship between clinical and EEG abnormalities was statistically analyzed. Results: In the majority of cases there were simple febrile seizures (82%) and unique seizures (62%). The recurrence rate of FS was higher for children with the first seizure bellow 12 months of age, and when the FS were complicated. Ninetyfive (8.1%) children showed focal epileptiform activity (EA) in the first EEG, and 3.4% had somatosensory evoked spikes by foot or hand stimulation. There was a increase in percentage of EA with the increase of age (3% until 12 months and 33% after 48 moths). Afebrile seizures subsequent to the FS occurred in 9,4% of the cases. EA, a family history of seizures, and the type of FS were not significant risk factors for subsequent afebrile seizures. Discussion: In order to understand the relationship between FS and the occurrence of epilepsy, and to evaluate possible cognitive and behaviour problems associated to the persistent epileptiform activity there is a need of longitudinal studies.

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“…Few reports make special mention of the EEG changes in acute Q fever, but Carausu [37] carried out 37 EEGs on 14 cases of acute Q fever (none of whom had major neurological signs): in three cases the EEG was normal, six had gross pathological abnormalities and five had borderline abnormalities. Wallace and colleague [15] in a study of 78 febrile children included two children each of 1-year-old who had serological evidence of acute Q fever and had fits: one had a pre-existing left hemiplegia which became worse during the febrile fit and slow wave activity, focal abnormalities and epileptic bursts of activity were shown on the EEG. The other child remained neurologically normal during the febrile fit and had a normal EEG.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Childhood infection is uncommon [8,9,[15][16][17][18]. The youngest child in the Plymouth series to have C. burnetii antibodies (phase II, 40) was a 3-year-old girl with aplastic anaemia.…”

Section: Clinical Featuresmentioning

confidence: 99%

Q fever in Plymouth, 1972–88: A review with particular reference to neurological manifestations

Reilly

Northwood

Caul³

1990

Epidemiol. Infect.

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SUMMARYBetween 1972 and 1988 we have serologically confirmed 103 Coxiella burnetii infections: 46 were acute, 5 were chronic, 52 represented past infections. Details of 61 cases are presented.Of acute cases 80 % had respiratory involvement; at least 63 % had pneumonias. The incidence (22 %) of neurological complications was of particular interest; 40% of these patients had prolonged sequelae. One acutely ill patient died of fulminating hepatitis. Patients with pre-existing pathology or immunosuppression were especially susceptible to C. burnetii.In the absence of acute sera, the complement fixation test alone provided inadequate differentiation between recent and past Q fever: phase II titres persisted at 3 80 for more than 1 year after the acute infection in 15 cases; maximum duration of persistence was 14 years. Three patients acquired high phase I titres.Only 5% of cases had chronic Q fever, but in view of the diverse sequelae observed in this series, we suggest that long-term serological and clinical followup of all cases of Q fever is fully justified.

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Neurological, Electroencephalographic, and Virological Findings in Febrile Children

Cited by 53 publications

References 29 publications

Role of viruses in febrile convulsions.

Role of viruses in febrile convulsions.

Crise febril: correlação clínico-eletrencefalográfica em 1162 crianças

Q fever in Plymouth, 1972–88: A review with particular reference to neurological manifestations

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