Predictors of clinically urgent intracranial pathology at neuroimaging in children with complex febrile seizures: a retrospective cross‐sectional study. (16th August 2019)

• Record Type: Journal Article
• Authors: Guillou, Tifenn; Carbajal, Ricardo; Rambaud, Jérome; Titomanlio, Luigi; de Pontual, Loic; Biscardi, Sandra; Nissack‐Obiketeki, Gisèle; Pellegrino, Béatrice; Charara, Oussama; Angoulvant, François; Denis, Julien; Chalard, Francois; Morel, Baptiste; Loschi, Solène; Chappuy, Hélène; Guedj, Romain
• Is Part Of: Acta pædiatrica. Volume 109:Number 2(2020)
• Page Start: 349
• Page End: 360
• Publication Date: 2019-08-16
• Subjects: febrile seizure -- Neuroimage -- paediatric emergency department; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.14938
• Languages: English
• ISSNs: 0803-5253

Abstract

Abstract: Aim: To assess the prevalence of clinically urgent intracranial pathology (CUIP) in children visiting the emergency department with a complex febrile seizure (CFS). Methods: Retrospective cohort review. We analysed the visits of patients for a CFS from January 2007 to December 2011 in seven paediatric emergency departments. Our main outcomes were the proportions of CUIP diagnosed between day 0 and 1 and within 30 days after the index visit. Results: From 1 183 487 visits, 839 were for a CFS and 130 (15.5%) of these had a neuroimaging performed within 30 days (CT scan for 75 visits [8.9%], MRI for 30 visits [3.6%] and both for 25 visits [3.0%]). Three CUIP were diagnosed between day 0 and 1 (0.4% [CI‐95%: 0.1‐1.3]), 5 within 30 days after the index visit (0.7% [CI‐95%: 0.2‐1.7]) but none among the 630 visits of children presenting with a normal neurological clinical examination (0% [95% CI: 0.0‐0.7]), nor among the 468 presenting only with multiple seizure (0% [95% CI: 0.0‐1.0]). Conclusion: In children with a CFS, CUIP is rare event in the subgroup of children with a normal neurological clinical examination and in those with brief generalised multiple seizures.