مقاله انگلیسی رایگان در مورد پذیرفتن بیماران مبتلا به تشنج ناشی از تب – الزویر 2017

Complex febrile seizures are a common cause for an Emergency Department (ED) visit. The prevalence of febrile seizures is ~2-5% in the United States, and approximately 25-35% of febrile seizures are classified as complex.1-4 Complex febrile seizures (CFSs) are defined as those with focality, prolonged duration (greater than 15 minutes), and/or multiple seizures within 24 hours.2 Approximately 20- 30% of children with a first febrile seizure will have subsequent febrile seizures.3-6 There are currently no clinical practice guidelines regarding management of CFS in the US. There are international guidelines by the Italian league against epilepsy (the Ad Hoc Task Force of LICE Guidelines)[5], the Joint Working Group of the Research Unit of the Royal College of Physicians and the British Paediatric Association Commission[6] and the world health organization guidelines[7], all calling for routine admission for observation for all patients presenting with CFS. These recommendations echo algorithms published in several review articles in the medical literature .[8, 9] Recent literature suggest that routine lumbar puncture and urgent neuroimaging are low yield and are not indications for admission after CFS.9-13 Thus indication for admission would typically be for observation or supportive care. Recommendations on if and in what time frame to perform EEG after CFS vary.2,3,14 . There is limited data on the utility of EEG in the acute period (<72 hours) after first time CFS.11, 15-17 Early EEG could be performed as inpatient or outpatient in most centers, but this study focuses on the inpatient setting The goals of this study were to assess the risk of recurrent seizures during admission and to determine whether EEG in the in the first 72 hours affects acute inpatient management.