Efficacy of an interventional educational programme in mitigating post-traumatic stress in parents who have witnessed a febrile seizure: a pilot before-and-after study

Abstract

ObjectivesTo measure post-traumatic stress in parents who have witnessed their child’s first simple febrile seizure and to assess the impact of workshops where information is dispensed, proper reactions are demonstrated and dialogue is encouraged on the mitigation of parental stress.DesignA pilot before-and-after study, with control group, using self-reported measures from the Impact of Event Scale-Revised.SettingData from two French participating centres.ParticipantsA total of 50 parents who witnessed their child’s first simple febrile seizure.InterventionParents selected themselves into either group 1: attending a workshop (intervention group), or group 2: no further management (control group).Primary and secondary outcome measures(1) Parental post-traumatic stress was assessed by the Impact of Event Scale-Revised a minimum of 4 weeks after the seizure (before any workshop if applicable). A high risk of developing post-traumatic stress disorder was indicated by a score ≥33. (2) To assess the efficacy of workshops on the mitigation of parental stress, all parents self-completed the Impact of Event Scale-Revised a second time at a minimum of 10 weeks after the seizure (after any workshop if applicable).ResultsFour weeks after the seizure, 76% of the total parents presented an Impact of Event Scale-Revised score ≥33. At 10 weeks after the seizure, the scores were 18.1 points lower (95% CI 11.66 to 24.61, P<0.0001) in group 1 versus only 5.51 points lower (95% CI 2.76 to 8.27, P=0.0003) in group 2 (intragroup comparison), and were significantly lower in group 1 compared with group 2 (intergroup comparison), P=0.02.ConclusionsParents who have witnessed their child’s first simple febrile seizure are at high risk of developing post-traumatic stress disorder 4 weeks after the seizure. Our innovative workshops are associated with a significant mitigation of the parental post-traumatic stress.

Clinical guideline: febrile seizures, diagnosis, and treatment

“…The only association found was between repeated FeS and a delay in language development; thus, new studies and longer-term follow-up will be required 42 . Hippocampal malformations do not appear to be a consequence of FeS but can be a predisposing factor for the development 7 . Providing the family with information about the illness and the risk of recurrence during the illness or in the future should be carried out by the pediatrician.…”

“…SFeS happen in children 3-5 months old [1][2][3][4] . They are generalized tonic-clonic seizures accompanied by fever, without central nervous system (CNS) infection, metabolic disorder, or history of FeS [5][6][7][8] . Fever is considered as a rectal temperature greater than 38°C, axillary temperature greater than 37.5°C, or tympanic temperature greater than 38.2°C 9 .…”

Guía clínica. Diagnóstico y tratamiento de crisis febriles

“…Las crisis febriles simples (CFeS) ocurren en niños de 3 meses a 5 años de edad [1][2][3][4] . Es una crisis tónico-clónica generalizada acompañada por fiebre sin infección del sistema nervioso central (SNC), trastorno metabólico, ni antecedentes de crisis afebriles [5][6][7][8] . Se considera fiebre una temperatura mayor de 38 °C rectal, mayor de 37.5 °C axilar o timpánica mayor de 38.2 °C9 .…”

“…Afectan al 2-5% de la población pediátrica y se ha reportado que son más frecuentes en algunos grupos étnicos asiáticos 3,13,14 . Son de carácter benigno, por ser convulsiones provocadas y no una epilepsia 7,13 .…”

“…Solo se encontró una asociación entre las CFe repetidas y un retraso en el desarrollo del lenguaje, que precisa de nuevos estudios y seguimientos a más largo plazo 42 . Las malformaciones del hipocampo no parecen ser una consecuencia de las CFe, más bien un factor predisponente asociado al desarrollo de epilepsia 7 . Es conveniente proporcionar a la familia información sobre la enfermedad y el riesgo de recurrencia durante la misma enfermedad o en el futuro; esto puede realizarlo el pediatra.…”