New guidelines for management of febrile seizures in Japan

Natsume, Jun; Hamano, Shin ichiro; Iyoda, Kuniaki; Kanemura, Hideaki; Kubota, Masaya; Mimaki, Masakazu; Niijima, Shinichi; Tanabe, Takuya; Yoshinaga, Harumi; Kojimahara, Noriko; Komaki, Hirohumi; Sugai, Kenji; Fukuda, Tokiko; Maegaki, Yoshihiro; Sugie, Hideo

doi:10.1016/j.braindev.2016.06.003

Cited by 69 publications

(91 citation statements)

References 48 publications

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“…Febrile seizure (FS) is the most common type of seizure observed in children. FS is characterized by episodes of convulsions that occur in association with fever in children aged between 3 months and 6 years without a central nervous system infections or electrolyte imbalance [1][2][3][4][5]. FS is believed to be a benign seizure syndrome, and is distinct from other neurologic disorders.…”

Section: Introductionmentioning

confidence: 99%

“…Diagnoses and initial managements of FS are aimed to exclude acute symptomatic seizure other than FS and early cessation of seizure with antiepileptic drugs (AEDs) [3,5]. The exclusions of acute symptomatic seizure are made based on clinical characteristics and diagnostic procedures such as lumber punctures (LP) and radiologic studies such as computed tomography (CT) and magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

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Recent practice patterns in diagnostic procedures anticonvulsants, and antibiotics for children hospitalized with febrile seizure

Okubo

Hayakawa

Nariai

et al. 2019

Seizure

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A B S T R A C TPurpose This study investigated clinical practice patterns for admissions due to FS at a national level.Method Discharge records were extracted for patients with FS aged < 6 years for the years 2010-16 using national inpatient database in Japan. We ascertained antiepileptic drug use, diagnostic procedures, healthcare costs, and length of hospital stays (LOS), using mixed effect linear or logistic regression models. We also investigated correlations between performance of lumbar puncture (LP), and use of head computed tomography (CT) and antibiotics.Results We identified a total of 94,452 eligible patients. Hospitalization costs and LOS in days decreased from 19,027 JPY and 4.6 days in 2010 to 18,753 JPY and 4.1 days in 2016. Phenytoin use decreased from 1.6% in 2010 to 0.5% in 2016, whereas fosphenytoin use increased from 0% in 2010 to 6.7% in 2016. Decreasing trends were observed in CT use (from 32.8% to 16.9%) and LP performance (16.9% to 13.5%). For the analyses at hospital levels, CT use and LP performance was positively correlated (r = 0.63). No correlations were observed between total and extremely broad-spectrum antibiotic use and CT use or LP performance in hospitals without cases of intensive care. Wide variations were observed across hospitals for performance of LP (0%-88%), use of CT (0%-84%) and antibiotics (10%-99%).Conclusion We provided novel insights into the current practice patterns for children with FS at individual levels, and delineated wide variations of LP, CT, and antibiotic use for the practices at hospital levels.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recent practice patterns in diagnostic procedures anticonvulsants, and antibiotics for children hospitalized with febrile seizure

Okubo

Hayakawa

Nariai

et al. 2019

Seizure

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“…One example is tepid sponging, which is not thought to be beneficial in preventing recurrence of FS though this is not proven with a clinical trial. Use of these measures may help to make the child feel comfortable only but not prevent recurrence of a seizure 14 . Conveying accurate information to the parents on the role of antipyretics will help to reduce unwarranted fear of fever in them 19 .…”

Section: Role Of Neuroimagingmentioning

confidence: 99%

“…Further, there is no evidence to indicate that any interventions made based on the findings in the EEG would alter the child's outcome in relation to development of epilepsy later in life 14 .…”

Section: Introductionmentioning

confidence: 99%

Management of simple febrile seizures

Wanigasinghe

2017

Sri Lanka J Child Health

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“…[11][12][13][14] Because of these studies, the use of sedative antihistamines in patients with past history of febrile seizure is not recommended in the guidelines released by the Japanese Society of Child Neurology in 2015. 15 However, the results of previous studies may have been limited in scope and validity, with selective inclusion of patients and a range of seizure durations that may suggest an influence of bias. In light of these concerns, we attempted to clarify the relationship between antihistamine use, particularly sedative antihistamines, and the duration of febrile seizure in a cross-sectional study that incorporated a detailed data collection effort.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Sedative Antihistamines and the Duration of Febrile Seizures

et al. 2020

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Some studies have shown that sedative antihistamines prolong febrile seizure duration. Although the collective evidence is still mixed, the Japanese Society of Child Neurology released guidelines in 2015 that contraindicated the use of sedative antihistamines in patients with febrile seizure. Focused on addressing limitations of previous studies, we conducted a cross-sectional study to evaluate the relationship between febrile seizure duration and the use of sedative antihistamines. Data were collected from patients who visited St. Luke's International Hospital due to febrile seizure between August 2013 and February 2016. Patients were divided into groups based on their prescribed medications: sedative antihistamine, nonsedative antihistamine, and no antihistamine. Seizure duration was the primary outcome and was examined using multivariate analyses. Of the 426 patients included, sedative antihistamines were administered to 24 patients. The median seizure duration was approximately 3 minutes in all three groups. There was no statistical difference in the bivariate (p = 0.422) or multivariate analyses (p = 0.544). Our results do not support the relationship between sedative antihistamine use and prolonged duration of febrile seizure. These results suggest that the use of antihistamines may be considered for patients with past history of febrile seizure, when appropriate.

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New guidelines for management of febrile seizures in Japan

Cited by 69 publications

References 48 publications

Recent practice patterns in diagnostic procedures anticonvulsants, and antibiotics for children hospitalized with febrile seizure

Recent practice patterns in diagnostic procedures anticonvulsants, and antibiotics for children hospitalized with febrile seizure

Management of simple febrile seizures

Relationship between Sedative Antihistamines and the Duration of Febrile Seizures

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