Predictors of clinically urgent intracranial pathology at neuroimaging in children with complex febrile seizures: a retrospective cross‐sectional study

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...

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Bibliographic Details
Published in:Acta Paediatrica 2020-02, Vol.109 (2), p.349-360
Main Authors: Guillou, Tifenn, Carbajal, Ricardo, Rambaud, Jérome, Titomanlio, Luigi, Pontual, Loic, Biscardi, Sandra, Nissack‐Obiketeki, Gisèle, Pellegrino, Béatrice, Charara, Oussama, Angoulvant, François, Denis, Julien, Chalard, Francois, Morel, Baptiste, Loschi, Solène, Chappuy, Hélène, Guedj, Romain
Format: Article
Language:English
Subjects:
Child
Children
Computed tomography
Convulsions & seizures
Cross-Sectional Studies
Emergency medical care
Emergency medical services
Emergency Service, Hospital
febrile seizure
Fever
Humans
Infant
Life Sciences
Magnetic resonance imaging
Medical imaging
Neuroimage
Neuroimaging
paediatric emergency department
Pathology
Retrospective Studies
Seizures
Seizures - diagnostic imaging
Seizures - epidemiology
Seizures, Febrile - diagnostic imaging
Seizures, Febrile - epidemiology
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Summary: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.
ISSN:0803-5253
1651-2227
DOI:10.1111/apa.14938