Risk of Intracranial Pathologic Conditions Requiring Emergency Intervention After a First Complex Febrile Seizure Episode Among Children

To determine the likelihood of intracranial pathologic conditions requiring emergency neurosurgical or medical intervention among children without meningitis who presented to the pediatric emergency department after a first complex febrile seizure. We performed a retrospective review of prospectivel...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2006-02, Vol.117 (2), p.304-308
Main Authors: Teng, David, Dayan, Peter, Tyler, Sarah, Hauser, W. Allen, Chan, Stephen, Leary, Linda, Hesdorffer, Dale
Format: Article
Language:English
Subjects:
Brain - diagnostic imaging
Brain - pathology
Brain Diseases - complications
Brain Diseases - diagnosis
Case studies
Children
Children & youth
Convulsions & seizures
Emergencies
Emergency Service, Hospital
Emergency services
Female
Fever
Health aspects
Health risk assessment
Humans
Infant
Magnetic Resonance Imaging
Male
Meningitis
Pathological physiology
Pathology
Pediatrics
Physiology, Pathological
Seizures, Febrile - complications
Seizures, Febrile - diagnosis
Surgery
Tomography, X-Ray Computed
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Summary:To determine the likelihood of intracranial pathologic conditions requiring emergency neurosurgical or medical intervention among children without meningitis who presented to the pediatric emergency department after a first complex febrile seizure. We performed a retrospective review of prospectively collected data for children in neurologically normal condition who presented to a single pediatric emergency department after a first complex febrile seizure (focal, multiple, or prolonged). The complex febrile seizure classification was determined independently by 2 epileptologists. The presence of intracranial pathologic conditions was determined through review of neuroimaging results, telephone interviews, or medical record review. Data for 71 children with first complex febrile seizures were analyzed. Fifty-one (72%) had a single complex feature (20 focal, 22 multiple, and 9 prolonged), and 20 (28%) had multiple complex features. None of the 71 patients (1-sided 95% confidence interval: 4%) had intracranial pathologic conditions that required emergency neurosurgical or medical intervention. For children with first complex febrile seizures, the risk of intracranial pathologic conditions that require emergency neurosurgical or medical intervention is low, which suggests that routine emergency neuroimaging for this population is unnecessary.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2005-0759