The duration of febrile seizures and peripheral leukocytosis

Stuijvenberg, Margriet van; Moll, Henriëtte A.; Steyerberg, Ewout W.; Gijssel, E. N. van; Moons, Karel G.M.; Derksen‐Lubsen, Gerarda

doi:10.1016/s0022-3476(98)70068-x

Cited by 13 publications

(16 citation statements)

References 7 publications

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“…Thus, in this study, the reason for leucocytosis was due to febrile episode rather than seizure event or duration. This is supported by other studies which showed no correlation between leucocytosis and seizure duration 4,18 .…”

Section: Discussionsupporting

confidence: 86%

“…Other investigations were done when necessary as decided by the treating physician. Total count >15000 per cu mm was regarded as leucocytosis 4 .…”

Section: Methodsmentioning

confidence: 99%

“…Many times we come across high total blood leucocyte count in these children. There are studies which have shown the direct effect of seizure on peripheral cell count 4,5 . Studies have also shown that the stress from fever or seizure results in leucocytosis with neutrophilic predominance following release of epinephrine 6 .…”

Section: Introductionmentioning

confidence: 99%

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Leucocytosis in Febrile Seizure

Rajbhandari

Aryal

2011

J. Nepal Paedtr. Soc.

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Introduction: Febrile seizure (FS) is a common condition affecting 2-5% of children. Peripheral blood leucocyte count with its differential is an initial test looking for the cause of fever and high count is usually accounted for the seizure activity. Objectives: To find the incidence of febrile seizure and to evaluate the relationship between fever duration before seizure, seizure duration and the total leucocyte as well as neutrophil response. Methodology: It is a cross sectional study done at Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal, for one year. After an informed consent, children from 6 months to 6 years with FS were admitted. Those with afebrile seizures and who refused to give consent were excluded. A detail history and examination was done on admission. All were investigated for the source of fever including total and differential count. Results: Out of a total 1742 children admitted, 115 (6.6%) children had febrile seizure. Simple febrile seizure was observed in 93(81%) and 22(19%) was complex febrile seizure. 42% of them had leucocytosis. The duration of fever before the onset of seizure is found to be negatively correlated with total leucocyte count (r = -0.418, p<0.001) and neutrophils count alone (r = -0.375, p<0.001). The duration of seizure is not correlated to both the total leucocyte count (r = -0.162, p = 0.85) and the neutrophil (r = -0.109, p= 0.247). Conclusion: The incidence of febrile seizure is 6.6%. Leucocytosis and neutrophilia in children is negatively correlated with the duration fever before the onset of seizure, associated with underlying infection if any and is not related to seizure event and its duration. Thus any child with febrile seizure with high leucocyte count should be evaluated for infection.

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Section: Discussionsupporting

confidence: 86%

“…Other investigations were done when necessary as decided by the treating physician. Total count >15000 per cu mm was regarded as leucocytosis 4 .…”

Section: Methodsmentioning

confidence: 99%

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Leucocytosis in Febrile Seizure

Rajbhandari

Aryal

2011

J. Nepal Paedtr. Soc.

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“…In two observational studies performed in Iran 10 and the Netherlands, 11 the researchers agreed that elevated WBC in FC cases is due to the underlying infection, not a result of convulsion as a stressor. Warden et al have recommended routine WBC assessment for children with FC in their systematic review about febrile seizure.…”

Section: Discussionmentioning

confidence: 99%

Leukocyte count and C reactive protein as diagnostic factors in febrile convulsion

et al. 2017

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Background: Febrile convulsion (FC) is the most common seizure disorder in childhood. White blood cell (WBC) and C reactive protein (CRP) are commonly measured in FC. Aims and Objectives: To compare WBC and CRP in febrile children, aged 6 months to five years, with and without FC, in order to determine whether leukocytosis and elevated CRP can be used as diagnostic tool for febrile seizure.. Materials and Methods: In this cross sectional study 214 children (112 with FC), aged 6 months to 5 years, admitted to in the first 48 hours of their febrile disease, either with or without seizure, were evaluated over a 12 months period. Age, sex, temperature; WBC, CRP and hemoglobin were recorded in all children. There was a significant increase of WBC (P <0.001) in children with FC so we can deduct that leukocytosis encountered in children with FC can be due to convulsion in itself. Results: When comparing FC and non-FC children, we encountered a significant increase of WBC (P =0.0005) in children with FC, measured at the time of admission to pediatric medicine ward. There was no significant difference regarding CRP between the two groups. In fact, elevated CRP is a result of underlying pathology.Conclusion: In stable patients, if there's no reason to suspect a bacterial infection or who don't have any indication of lumbar puncture, there's no need to assess WBC as an indicator of underlying infection. Any child with febrile seizure with a high CRP value should be evaluated for infection

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“…25 Another group led by van Stuijvenberg studied 203 children with febrile seizures and recommended that leukocyte counts should be used to evaluate the underlying cause of fever because of misinterpretation of high leukocytes counts because of fever duration. 26 Vomiting was also a common non-specific symptom in children with leukocytosis without SBI. The association is purely conjectural and there is no literature available pertaining to this observation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of predictive value of total leukocyte count in acute serious bacterial infections in children 1 month to 5 years

Dharmalingam

Vignesh

Raghupathy

et al. 2017

Int J Contemp Pediatr

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Background: Fever in a young child is a frequently encountered clinical problem with various causes. Most of them run a benign self-limiting course that requires only symptomatic treatment. However, in a few children the underlying etiology can be a life threatening serious bacterial infection (SBI). Early identification of SBI is warranted because of the need to start antibiotic therapy, often empirical, as soon as possible to prevent morbid sequela. Total leukocyte count (TLC) is with neutrophil predominance is considered to be a surrogate marker of a bacterial infection and facilitating decision - making regarding further evaluation and empiric antibiotic therapy. The purpose of this study was to determine the utility of leukocyte in predicting SBI in a young febrile child and to correlate the leukocyte count with non-serious infection.Methods: One fifty children, age of 1 month to 60 months with fever > 38°c are included and were analyzed for demographic details, presenting symptoms, physical examination findings, clinical diagnosis, total leukocyte count, peripheral smear study, blood culture, stool culture, CSF analysis, x-ray chest, abdominal ultrasound, CT-brain. Results: Out of 150 children included in the study, the mean age was 26.7±14.54 months and the average duration of fever was 4.3±1.02 days. The mean leukocyte count was 15016.43±5801.98 cells/cu.mm. 74 children had proven serious bacterial infection (49.3%) and were categorized in Group I and remaining non-serious infection were 50.66% are belonged to Group 2. Urinary tract infection and pneumonia were the most common SBI encountered (31/20/68.91%). The highest TLC counts were seen in children with UTI. Analysis of variance (ANNOVA) did not reveal significant differences in TLC between children with different diagnosis. In Group 2, majority of the etiology was lower respiratory tract infection/inflammation and short febrile illness.Conclusions: SBI comprise only half of the febrile children with leukocytosis. The predictive accuracy of leukocytosis in diagnosing SBI is poor. Vomiting and seizures probably incite stress mediated leukocytosis and are commonly encountered in febrile child with a high TLC without SBI. Further models with addition of clinical data and other surrogates of infection need to be developed to improve prediction of SBI in a febrile child.

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The duration of febrile seizures and peripheral leukocytosis

Cited by 13 publications

References 7 publications

Leucocytosis in Febrile Seizure

Leucocytosis in Febrile Seizure

Leukocyte count and C reactive protein as diagnostic factors in febrile convulsion

Evaluation of predictive value of total leukocyte count in acute serious bacterial infections in children 1 month to 5 years

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