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Predictors of clinically urgent intracranial pathology at neuroimaging in children with complex febrile seizures : a retrospective cross‐sectional study
Author(s) -
Guillou Tifenn,
Carbajal Ricardo,
Rambaud Jérome,
Titomanlio Luigi,
Pontual Loic,
Biscardi Sandra,
NissackObiketeki Gisèle,
Pellegrino Béatrice,
Charara Oussama,
Angoulvant François,
Denis Julien,
Chalard Francois,
Morel Baptiste,
Loschi Solène,
Chappuy Hélène,
Guedj Romain
Publication year - 2020
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14938
Subject(s) - medicine , pediatrics , neuroimaging , emergency department , retrospective cohort study , cohort , febrile seizure , epilepsy , psychiatry
Aim To assess the prevalence of clinically urgent intracranial pathology (CUIP) in children visiting the emergency department with a complex febrile seizure (CFS). Methods Retrospective cohort review. We analysed the visits of patients for a CFS from January 2007 to December 2011 in seven paediatric emergency departments. Our main outcomes were the proportions of CUIP diagnosed between day 0 and 1 and within 30 days after the index visit. Results From 1 183 487 visits, 839 were for a CFS and 130 (15.5%) of these had a neuroimaging performed within 30 days (CT scan for 75 visits [8.9%], MRI for 30 visits [3.6%] and both for 25 visits [3.0%]). Three CUIP were diagnosed between day 0 and 1 (0.4% [CI‐95%: 0.1‐1.3]), 5 within 30 days after the index visit (0.7% [CI‐95%: 0.2‐1.7]) but none among the 630 visits of children presenting with a normal neurological clinical examination (0% [95% CI: 0.0‐0.7]), nor among the 468 presenting only with multiple seizure (0% [95% CI: 0.0‐1.0]). Conclusion In children with a CFS, CUIP is rare event in the subgroup of children with a normal neurological clinical examination and in those with brief generalised multiple seizures.