Respiratory viruses and febrile response in children with febrile seizures: A cohort study and embedded case-control study

Hautala, Maria; Arvila, Jukka; Pokka, Tytti; Mikkonen, Kirsi; Koskela, Ulla; Helander, Heli; Glumoff, Virpi; Rantala, Heikki; Tapiainen, Terhi

doi:10.1016/j.seizure.2020.11.007

Cited by 22 publications

(33 citation statements)

References 44 publications

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“…Though young age, especially under 12 months, is a known risk factor for SE [27] , 4 of our 5 patients with SE were 5-17 years of age. Interestingly, in a cohort of 225 children presenting with febrile seizures and evidence of respiratory viral infection between 2013 and 2017, coronaviruses were associated with seizures in children ages 3-6 years but not 0.5-3 years [28] . In accordance to our findings, Brisca et al reported two girls, five and 11 years old, with prior history of well controlled epilepsy, who presented with fever and prolonged seizures due to SARS-CoV-2 infection [11] .…”

Section: Discussionmentioning

confidence: 99%

Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children

Kurd

Hashavya

Benenson

et al. 2021

Seizure

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Objectives To explore the rate, characteristics, risk factors, and prognosis of children presenting with seizures as the main symptom of acute COVID-19 (coronavirus disease 2019). Methods We conducted a systematic retrospective study to identify all children who presented to the emergency departments of a tertiary academic medical center between March 1st and December 31st 2020 and had a SARS-CoV-2 infection based on RT-PCR (reverse transcription-polymerase chain reaction) from nasopharyngeal swab. Clinical and demographic data were extracted from the electronic medical records and reviewed. Results Total of 175 children were diagnosed with acute SARS-CoV-2 infection in the emergency departments during the study period. Of those, 11 presented with seizures. Age ranged from six months to 17 years and 4 were girls. Five presented with status epilepticus and responded to loading doses of anti-seizure medications. Six had fever. Seven had prior history of neurological disorder. Full recovery was the rule. Significance Unlike in adults, seizures occur early and may be the main manifestation of acute COVID-19 in children. Seizures, including status epilepticus, may occur without fever even in children with no history of epilepsy and are not associated with severe disease. A high index of suspicion is required for early diagnosis thus infection control measures can be taken.

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Section: Discussionmentioning

confidence: 99%

Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children

Kurd

Hashavya

Benenson

et al. 2021

Seizure

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“…The most common underlying conditions are respiratory tract infections and gastroenteritis [ 18 ]. A recent study showed that influenza and coronaviruses cause respiratory tract infections leading to a febrile seizure more often than other respiratory viruses [ 11 ]. According to the Generation R study, frequent fever episodes are associated with an increased risk of febrile seizures in the second and third years of life [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Febrile seizures: perceptions and knowledge of parents of affected and unaffected children

et al. 2021

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Febrile seizures (FS) in children are common, but little is known about parents’ perceptions and knowledge of FS. We interviewed parents of children aged 6 months to 6 years affected by FS (FS group, 65 parents) or unaffected (control group, 54 parents). In the FS group, 32% said they knew their child had an FS when the first event occurred, and 89% described fear when the child had a seizure, with a median intensity of 10/10 (Q25/Q75: 9/10). Related to follow-up, 77% in the FS group (will) observe their child more carefully after the first seizure happened, and 63% (will) give antipyretics earlier at a median temperature of 38.2 °C (100.8 °F). In the FS group, 62% were unaware of FS before the first event (54% of control group did not know about FS thus far, n.s.). In the FS group, 20% would put a solid object in the mouth of a child having a seizure (control group, 39%, p = 0.030), and 92% would administer an available anti-seizure rescue medication (control group, 78%, p = 0.019). In the FS group, 71% feared that children with FS might suffocate (control group, 70%, n.s.).Conclusion: Information about FS and their management should be more available to improve parents’ coping and patient safety. What is Known:• Febrile seizures in children are common.• The prognosis of children suffering from febrile seizures is usually rather good. What is New:• Over half of parents had not informed themselves about febrile seizures so far; and only 32% of parents realized their child had a febrile seizure when it occurred.• Most parents described own fear with a median intensity of 10/10; and 63% (will) give antipyretics earlier at a median temperature of 38.2 °C (100.8 °F).

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“…Finally, 11 papers were included in qualitative and quantitative analysis, and are summarized in Table 2 and Table 3 . Briefly, the studies covered a timeframe ranging from 1993 to 2018, with 7 studies published before 2010 [ 16 , 17 , 29 , 30 , 31 , 32 , 33 ], and only 4 further reports since then [ 34 , 35 , 36 , 37 ]; 4 of the included studies [ 16 , 17 , 29 , 30 ] were from the United States, 2 studies were reports from China or Hong Kong [ 31 , 33 ], while the remaining reports were from Germany [ 32 ], South Korea [ 34 ], Finland [ 35 ], France [ 36 ], and South Africa [ 37 ]. Most of the aforementioned studies were observational reports from a single center [ 16 , 17 , 29 , 30 , 31 , 33 , 34 , 35 , 36 ], three of which included cases from PICU [ 30 , 33 , 36 ], while only two were multicentric reports [ 32 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

Respiratory Syncytial Virus: An Uncommon Cause of Febrile Seizures—Results from a Systematic Review and Meta-Analysis

et al. 2022

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Human Respiratory Syncytial Virus (RSV) is a highly contagious viral pathogen. In infants, it is usually listed among the main causes of medical referrals and hospitalizations, particularly among newborns, and a considerable base of evidence associates RSV infections and bronchiolitis with long-term neurological sequelae. We specifically performed a systematic review and meta-analysis in order to ascertain whether RSV infections may be associated with an increased risk for febrile seizures (FS) in infected infants. According to the PRISMA statement, Pubmed, Embase, and pre-print archive medRxiv.og were searched for eligible observational studies published up to 1 July 2022. Raw data included the incidence of FS among children admitted for influenza-like illness (ILI) and/or bronchiolitis, with a confirmed diagnosis of RSV or seasonal influenza virus (SIV) infection. Data were then pooled in a random-effects model. Heterogeneity was assessed using the I2 measure, while reporting bias was assessed by means of funnel plots and regression analysis. A total of 11 studies including 6847 cases of RSV infections were retrieved, with a pooled prevalence of 29.975 cases of FS per 1000 RSV cases (I2 = 88.5%). The prevalence was not substantially greater in studies performed in pediatric intensive care units (53.817 per 1000 RSV cases vs. 23.552, p = 0.12). Higher occurrence of FS was reported from studies performed after 2010 (Risk Ratio [RR] 1.429, 95% Confidence Interval [95%CI] 1.049–1.948), and in China (RR 2.105, 95%CI 1.356–3.266) and South Africa (RR 1.722, 95%CI 1.060–2.824) than in Europe, while a lower occurrence was reported form the USA (RR 0.414, 95%CI 0.265–0.649). Eventually, FS were less likely reported from RSV cases compared to subjects affected by seasonal influenza (RR 0.402; 95%CI 0.228–0.708). Although RSV is often associated with high risk of neurological complications, substantially less cases of FS are reported than in SIV infections. However, the paucity of available studies recommends a cautious appraisal of aforementioned results.

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Respiratory viruses and febrile response in children with febrile seizures: A cohort study and embedded case-control study

Cited by 22 publications

References 44 publications

Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children

Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children

Febrile seizures: perceptions and knowledge of parents of affected and unaffected children

Respiratory Syncytial Virus: An Uncommon Cause of Febrile Seizures—Results from a Systematic Review and Meta-Analysis

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