FACTORS PROGNOSTIC OF UNPROVOKED SEIZURES AFTER FEBRILE CONVULSIONS
FACTORS PROGNOSTIC OF UNPROVOKED SEIZURES AFTER FEBRILE CONVULSIONS
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DOI：
10.1056/nejm198702263160901
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发表时间：
1987-02-26
影响因子：
158.5
通讯作者：
KURLAND, LT
中科院分区：
文献类型：
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作者：
ANNEGERS, JF;HAUSER, WA;KURLAND, LT
我们评估了居住在明尼苏达州罗切斯特的687名最初有热性惊厥的儿童在热性惊厥后无缘性惊厥的风险及其预后因素。总体而言，患有热性惊厥的儿童无缘无故癫痫发作的次数增加了五倍，25岁之前的风险为7%。在患有简单热性惊厥的儿童中，风险从2.4%到有单一复杂特征的儿童中的6%至8%-即局灶性或长时间癫痫发作，或同一疾病的热性惊厥反复发作。对于具有其中任何两种复杂特征的儿童，风险为17%至22%，对于具有全部三种特征的儿童，风险为49%。随后的部分无缘性癫痫的发生与所有这三个复杂特征都密切相关，而随后的全身性无缘性癫痫发作的发生与热性惊厥的次数和无缘性癫痫的家族史有关。这些结果与以下观点是一致的，即全面性无端发作的风险增加反映了单纯性发热性惊厥和全面性无端发作的倾向。另一方面，复杂的热性惊厥和部分性发作之间的联系可能反映了一种因果联系或先前存在的大脑疾病的存在，这两种疾病都是导致复杂的热性惊厥和后来的部分性惊厥的原因。
We evaluated the risk of unprovoked seizures after febrile convulsions and the factors prognostic of them in a cohort of 687 children who had an initial febrile seizure while residing in Rochester, Minnesota. Overall children with febrile convulsions had a fivefold excess of unprovoked seizures, and the risk until the age of 25 was 7 percent. The risk ranged from 2.4 percent among children with simple febrile convulsions to 6 to 8 percent among children with a single complex feature-i.e., focal or prolonged seizures or repeated episodes of febrile convulsions with the same illness. For children with any two of the complex features, the risk was 17 to 22 percent, and for those with all three features, 49 percent. The occurrence of subsequent partial unprovoked seizures was strongly associated with all three of the complex features, whereas the occurrence of subsequent unprovoked seizures of generalized onset was associated with the number of febrile convulsions and a family history of unprovoked seizures. These results are consistent with the view that the increased risk of generalized-onset unprovoked seizures reflects a predisposition to both simple febrile convulsions and generalized-onset unprovoked seizures. The association between complex febrile convulsions and partial seizures, on the other hand, may reflect either a causal association or the presence of preexisting brain disease that is responsible for both the complex febrile seizures and later partial seizures.