[Clinical characteristics at onset of first febrile convulsions]

The aim of this retrospective study was to establish clinical characteristics of first febrile convulsions in children admitted to Department of Pediatrics in Tuzla, Bosnia and Herzegovina, and diagnosed with febrile convulsions in the period from January 1, 1999 till December 31, 2004.

Data were collected from medical records of the children admitted to Department of Pediatrics in Tuzla during the study period. The study included 716 medical records of children aged from one month to 7 years, analyzed for the following data: type of seizure (simple or complex), clinical manifestation of the convulsion (tonic-clonic, tonic, atonic, partial unilateral), body temperature after convulsion, and the length of convulsion. Of laboratory tests, the findings indicating possible infection and electroencephalogram (EEG) results were analyzed. Study subjects were divided into four age groups: 1-12 months (infants), 13 months to 2.9 years (young), 3 to 4.9 years (middle) and 5-7 years (older) groups. The chi2-test and Kruskal-Wallis test were used on testing statistical significance of between-group differences. The level of statistical significance was set at p < 0.05.

Simple febrile convulsions were found in 88.8% and complex febrile convulsions in 11.2% of children (p = 0.0016). Tonic-clonic seizures were recorded in 90% and atonic in 8.6% of cases (p < 0.0001). Body temperature immediately after febrile convulsions ranged between 38 degrees C and 41.5 degrees C. Kruskal-Wallis test produced no statistically significant difference between the groups tested. Febrile convulsions lasted up to 5 minutes in 73.5% of cases, with the highest recorded in younger group (76.7%); 17.3% of children had seizures lasting between 6 and 10 minutes, mostly in older group (39%). Normal EEG findings were recorded in 96.9%, specifically altered findings in 1.4% and non-specifically altered findings in 1.7% of patients.

The significantly higher prevalence of simple febrile convulsions as compared with complex forms and tonic-clonic seizure as the most common clinical manifestation of the attacks, recorded in the present study, were also confirmed in previous retrospective and prospective studies. It occurs with elevated body temperature above 38 degrees C. In the greatest proportion of children, it lasted for up to 15 minutes, and most children with febrile convulsions had normal EEG findings.

Data on the clinical characteristics of first febrile convulsions in the Tuzla Canton, Bosnia and Herzegovina, recorded in the present study, may prove useful on planning the programs of pediatric health care in the region.