KK Chan, SWW Cherk, CH Chan, DKK Ng, JCS Ho

Abstract

Febrile convulsion is the most common convulsive disorder in childhood. Many parents who had witnessed a child's first convulsion think that their child is going to die or is already dead. Intense parental anxiety and fear for recurrence is observed. Risk factors for recurrence of febrile convulsion is available in overseas studies but only limited local data is available. Objective: To determine the risk factors for recurrence of patients admitted for first febrile convulsion. Methods: The records of patients, admitted to Kwong Wah Hospital for first febrile convulsion from January 2002 to December 2004 were reviewed. Demographic data, characters of seizure, family history of febrile convulsion and epilepsy in first-degree relatives, investigations done and aetiology identified were noted. Outcome was measured in January 2007 with follow-up phone call made to re-confirm family history of seizure disorders and outcome of the patient. Results: One hundred and eighty-one patients were admitted for first febrile convulsion in the period studied. Out of 181 patients, 159 were valid for analysis, 22 failed contact. The most common seizure type was generalised tonic-clonic seizure, occurred in 82 patients (51.6%). Complex febrile seizure was observed in 37 patients (23.3%). Positive family history of febrile convulsion and epilepsy in first-degree relatives was noted in 29 patients (18.2%) and 4 patients (2.5%) respectively. Recurrence of febrile convulsion occurred in 36 patients (22.6%) and development of epilepsy in 2 patients (1.3%). Multivariate logistic regression showed young age was the only significant risk factor for the recurrence of febrile convulsion (p<0.001). Conclusion: For first febrile convulsion, 22.6% recurred and young age was the only significant risk factor for recurrence.

熱性驚厥是兒童時期最常見的驚厥性疾病。許多親眼目睹小孩首次驚厥發作的父母認為他們的孩子會死或已經死了。可見父母親對於再次驚厥發作是很焦慮與恐懼的。對於熱性驚厥反復發作的危險因素雖然國外已有報導，但僅僅是基於當地的有限數據。目的：確定首次驚厥發作後反復再發的危險因素。方法：收集 2002 年 1 月至 2004 年 12 月首次驚厥發作於廣華醫院住院的病人。記錄人口統計資料、抽搐特點、熱性驚厥的家族史和一代親屬的癲癇史、檢查結果及確定的病原。在 2007 年 1 月通過電話聯繫方式再次確定家族抽搐病史及病人的最終情況。

結果：在研究期間有 181 例首次驚厥發作的住院患者，其中有 159 例進行了有效分析，有 22 例脫失。最常見的抽搐類型是全身性強直─陣攣性發作，共有 82 例（佔 51.6%）；複雜型熱性驚厥有 37 例（佔 23.3%）；有熱性驚厥家族史和一代親屬癲癇史的分別有 29 例（佔 18.2%）和 4 例（佔 2.5%）；反復驚厥發作有佔36 例（佔 22.6%）；有 2 例（佔 1.3%）最終發展為癲癇。多元回歸分析結果顯示年幼是引起熱性驚厥反復發作的唯一重要的危險因素（P<0.001）。結論：首次熱性驚厥患者有 22.6% 的比例會出現驚厥反復發作，而且年幼是引起反復發作的唯一最重要的危險因素。