열성 경련 재발의 위험인자
Predictors of Recurrent Febrile Seizure
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목적:제주도에 거주하는 환자들을 대상으로 하여 열성 경련의 특징을 분석하고 재발성 열성경련의 예측인자에 대해서도 살펴보고자 한다 . 방법: 2005년 7월부터 2013년 6월까지 생후 3개월에서 만 5세 이하에서 첫 열성 경련으로 제주대학교병원에 방문한 환자들을 연구대상으로 하였다 . 307명의 환자에 대해 의무기록을 통한 후향적 고찰을하였다 . 결과: 첫 열성 경련 발생 당시의 연령은 평균 18.4개월이었으며 88 %가 6개월에서 3세 사이에 첫 열성 경련이 발생하였다 . 첫 열성 경련 후 첫번째 재발 유무에 대한 분석에서 15개월 이하 열성경련과 열성경련의 가족력, 두 가지 변수가 다변량 분석에서 열성 경련 재발에 독립적으로 영향을 주는 인자로 밝혀졌다 . 15개월 이하 열성 경련은 P= 0.002, 열성 경련의 가족력은 P=0.001이었다 . 2회 이상 재발 유무에 대한 분석에서 15개월 이하 첫 열성 경련은 P=0.004이었고 열성 경련의가족력은 P=0.068으로경계선상의통계적인의미를보였다 . 결론:본 연구에서 15개월 이하 에서 첫열성 경련의 발생과 열성경련의 가족력이 열성 경련의 재발에 영향을 주는 독립적인 위험인자로 확인되었다 .
Abstract
Purpose: We performed this study to investigate the clinical features of febrile seizure (FS) and to identify prognostic factors of recurrence of FS on Jeju Island, South Korea. Methods: A hospital-based retrospective study was performed in 307 children with FS whose first episode developed between July 2005 and June 2013 seen at the Pediatric Department of Jeju National University Hospital. Results: 307 children (189 boys and 118 girls) were enrolled in this study. Based on first FS semiology, 97.1% (298/307) of cases manifested as generalized seizure and 2.9% of cases showed focal seizure. Moreover, 23.5% (72/307) of cases had complex FS as the first FS. The average age at the first FS was 18.4 months. A family history of FS or epilepsy was found in 30.6% and 5.2% of patients, respectively. Recurrence occurred in 67.6% of patients; among them, 93.7% had their first recurrence within 1 year. Multivariate analysis identified the following factors as significant predictors of recurrence of FS: early onset of FS (≤15 months of age) and a family history of FS. Conclusions: We identified the following risk factors for recurrence of FS: early onset of FS (≤15 months of age) and a family history of FS.
참고문헌 (26)
- Verity CM, "Febrile convulsions in a national cohort followed up from birth. I-prevalence and recurrence in the first five years of life", Br Med J(Clin Res Ed), 290, pp.1307~1310 (1985)
- Berg AT, "Predictors of recurrent febrile seizures. a prospective cohort study", Arch Pediatr Adolesc Med, 151, pp.371~378 (1997)
- Pavlidou E, "Which factors determine febrile seizure recurrence? A prospective study", Brain Dev, 30, pp.7~13 (2008)
- Annegers JF, "Recurrence of febrile convulsions in a population-based cohort", Epilepsy Res, 5, pp.209~216 (1990)
- Berg AT, "A prospective study of recurrent febrile seizures", N Engl J Med, 327, pp.1122~1127 (1992)
- Camfield PR, "Prevention of recurrent febrile seizures", J Pediatr, 126, pp.929~930 (1995)
- Tarkka R, "Risk of recurrence and outcome after the first febrile seizure", Pediatr Neurol, 18, pp.218~220 (1998)
- Waruiru C, "Febrile seizures : an update", Arch Dis Child, 89, pp.751~756 (2004)
- Pavlidou E, "Effectiveness of intermittent diazepam prophylaxis in febrile seizures : long-term prospective controlled study", J child Neurol, 21, pp.1036~1040 (2006)
- Nelson KB, "Prognosis in children with febrile seizures", Pediatrics, 61, pp.720~727 (1978)
- Pavlidou E, "Febrile seizures : recent developments and unanswered questions", Childs Nerv Syst, 29, pp.2011~2017 (2013)
- Tarkka R, "Risk of recurrence and outcome after the first febrile seizure", Pediatr Neurol, 18, pp.218~220 (1998)
- Pickering LK, "Infections in day care", Pediatr infect Dis J, 6, pp.614~617 (1987)
- Nelson KB, "Predictors of epilepsy in children who have experienced febrile seizures", N Engl J Med, 295, pp.1029~1033 (1976)
- 문수정, "열성 경련 재발의 위험인자와 그들의 조합에 따른 재발률 조사", Korean Journal of Pediatrics, 45(11), pp.13~1410 (2002), 대한소아과학회
- Offringa M, "Risk factors for seizure recurrence in children with febrile seizures : A pooled analysis of individual patient data from five studies", J Pediatr, 124, pp.574~584 (1994)
- Lee GW, "Risk factors of recurrent febrile convulsion", J Korean Child Neurol Soc, 6, pp.263~268 (1999)
- Seo SH, "A study of the recurrent febrile seizure", J Korean Child Neurol Soc, 1, pp.90~98 (1993)
- Bae EJ, "Risk factors for recurrence of febrile seizure in children", J Korean Child Neurol Soc, 9, pp.368~374 (2001)
- Berg AT, "Predictors of recurrent febrile seizures; a metaanalytic review", J Pediatr, 116, pp.329~337 (1990)
- Knudsen FU, "Recurrence risk after first febrile seizure and effect of short term diazepam prophylaxis", Arch Dis Child, 60, pp.1045~1049 (1985)
- Capovilla G, "Recommendations for the management of febrile seizures. Ad hoc Task Force of LICE Guidelines Commission", Epilepsia, 50(Suppl 1), pp.2~6 (2009)
- Wallace, SJ., "Recurrence of febrile convulsions", Arch Dis Child, 49, pp.763~765 (1974)
- Offringa M, "Seizure recurrence after a first seizure : a multivariate approach", Dev Med Child Neurol, 34, pp.15~24 (1992)
- Rantala H, "Risk factors for recurrences of febrile convulsions", Acta Neurol Scand, 90, pp.207~210 (1994)
- Van den Berg BJ., "Studies on convulsive disorders in young children. III. recurrence of febrile convulsions", Epilepsia, 15, pp.177~190 (1974)