Clinical profile of children presenting with ferbrile seizures and febrile status epilepticus at the University Teaching Hospital, Lusaka
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Date
2017
Authors
Chandwe, Kanta
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
Febrile seizures (FS) are the most common seizure disorder in childhood. FS and febrile
status epilepticus (FSE) are a common presentation at the University Teaching Hospital
(UTH) in Lusaka, Zambia. Despite this, the clinical characteristics of children with FS
and the associated causes of fever have not been documented. Simple FS have no serious
adverse outcome on the neurological development of the child while complex febrile
seizures (CFS) have been shown to increase the risk of developing epilepsy. This study
sought to document the clinical characteristics of children with FS and FSE as well as
document the association of FS/FSE with malaria, HIV and Human herpesvirus-6
(HHV-6) at the UTH, Lusaka, Zambia. This was a case control study carried out in the
Department of Paediatrics and Child Health, UTH. Recruitment of participants began in
January, 2015 and ended in May, 2016. Participants ages ranged from 6 - 60 months and
had a febrile illness with or without FS. Febrile seizures were defined as seizures
occurring in febrile children between the ages of 6-60 months who did not have an
intracranial infection or history of afebrile seizures. A medical history and physical
examination was carried out on eligible participants and blood was drawn for the
detection of malaria, HIV and HHV-6.The peak age for the FS was 18-36 months. There
was significantly more children with FS than those without seizures in the 18-36 months
age group. There was no significant differences in sex distribution as well as temperature
level between the two groups. A family history of FS was noted in 14% of the
participants with FS compared to 2% in those without seizures.Acute febrile illness
without focus was the number one diagnosis associated with FS. Tonsillitis, coryza and
malaria were other diagnoses made with malaria accounting for 15 % of the cases with
FS and 11% of children with febrile illness. Among the children with FS, 54% had CFS
with 13% having FSE. Of the participants with FSE, 52% had acute febrile illness
without focus and 24% had malaria. CFS were noted in 56% of the seizures associated
with malaria of which 36 % met the criteria for FSE. The HIV prevalence was 2.2% with
no significant differences between children with FS and those without seizures. In this
study, the clinical characteristics of children with FS and FSE were found to be similar to
that described in worldwide studies and in malaria endemic regions. There was a higher
incidence of CFS/FSE compared to western reports but similar to what has been
documented in other SSA studies. It is recommended to follow up children presenting
with CFS/FSE, particularly those associated with malaria, due to the higher risk of
developing neurological deficit and epilepsy. The result for HHV-6 differed significantly
with world literature and the local studies, therefore a repeat testing is advisable
Description
Thesis
Keywords
Epilepsy therapy--Children--Zambia , Febrile seizures and febrile status epilepticus--Associated with HIVand malaria--Zambia