Clinical profile of admitted children with febrile seizures

Objective: The objectives of this study were toevaluate the clinical profile, investigations, treatmentsand outcome of hospitalized children with febrileseizures.Methods: A series of 69 consecutive children withfebrile seizures was identified by chart review from 1stJanuary 1997 to 1st January 2002 at King Abdul-AzizUniversity Hospital in Jeddah, Kingdom of Saudi Arabia.Clinical, laboratory, EEG, and neuroimaging data wereevaluated by one investigator using a structured datacollection form.Results: The children’s ages ranged between 7-70months (mean 20, SD 14), and 59.5% were males. Thesource of the febrile illness was evident in 65%, however,most admitted children (60 out of 69) had atypicalseizures (55%), were ill looking (24.5%), had febrilestatus (17.5%), or positive meningeal irritation signs(4%). Electrolyte abnormalities were uncommon (10%),however, complete blood count was abnormal in 45%,which increased the likelihood of receiving intravenousantibiotics (p=0.01). Lumbar puncture was performed on75%, particularly those with a first seizure (odds ratio[OR] 3.8, 95% confidence interval [CI] 0.9-15) oryounger than 2 years of age (OR 3.4, 95% CI 0.7-17).Brain CT was performed in 13% and EEG in 33%.Obtaining an EEG was less likely if the seizures weretypical (13% versus 50% in atypical, p=0.002). Durationof hospitalization ranged between 1-14 days (mean 4.7,SD 3.2), and only one child had meningitis, which waspredicted clinically.Conclusions: Pediatricians are selective in admittingand investigating children with febrile seizures. Thechildren frequently had atypical seizures, statusepilepticus, or were ill looking. The yield ofinvestigations remains low and does not justify extensivework-up or prolonged hospitalization.