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Is There Any Need for Emergency Neuroimaging in Children With first Complex Febrile Seizure?
Afagh Hassanzadeh Rad1, Manijeh Tabrizi1, Peyman Dadashzadeh1
1Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Insights
Emergency neuroimaging is not mandatory for children experiencing their first febrile convulsion (FC), especially when no red flags like developmental issues or head trauma are present. This finding is crucial given limited access and high costs associated with neuroimaging.
Area of Science:
- Pediatric Neurology
- Emergency Medicine
- Radiology
Background:
- Febrile convulsions (FC) are common in young children.
- The necessity of emergency neuroimaging for first-time FC is debated.
- Limited resources and risks associated with imaging necessitate clear guidelines.
Purpose of the Study:
- To evaluate the need for emergency neuroimaging in children presenting with their first febrile convulsion (CFC).
- To identify clinical factors influencing the decision for neuroimaging in pediatric FC.
- To inform clinical practice and resource allocation in regions with limited neuroimaging access.
Main Methods:
- Analytic cross-sectional study involving 111 children aged 6-60 months with first CFC.
- Data collected included demographics, fever characteristics, convulsion details, and family history.
- Fisher Exact Test used for data analysis in SPSS version 19.
Main Results:
- The study included 111 children with a mean age of 21.18 months.
- Multiple focal prolonged FC was the most frequent type observed.
- Only 2 non-significant abnormal neuroimaging results were found, with upper respiratory infection being the most common diagnosis.
Conclusions:
- Emergency neuroimaging is not mandatory for first CFC without concerning factors like developmental disorders, abnormal neurological exam, underlying neurological conditions, or head trauma.
- This finding is particularly relevant for healthcare systems with limited neuroimaging availability, high costs, and childhood irradiation risks.
- The study supports a more selective approach to neuroimaging in pediatric febrile convulsions.
Objectives:
The current study aimed to assess the need for emergency neuroimaging in children with first CFC.
Materials And Methods:
This is an analytic cross-sectional study conducted on children aged 6-60 months with first CFC. Data were gathered by a form that evaluates age, sex, imaging type, body temperature, and the duration of fever before convulsion, the duration and frequency of convulsion, and family history of FC. Data were analyzed via the Fisher Exact Test in SPSS version 19.
Results:
A total of 111 patients participated in this study with first CFC and mean age of 21.18±11.83 months. Regarding the type of CFC, the results showed that the highest and lowest frequencies belonged to multiple and multiple focal prolonged FC, respectively. Upper respiratory infection was the most common diagnosis. Also, 2 nonsignificant abnormal neuroimaging results were noted.
Conclusion:
Performing emergency neuroimaging in patients with first CFC was not mandatory in the absence of developmental disorders, abnormal neurologic examination, underlying neurological disorder, and head trauma. This is an important result in our country due to the lack of access to neuroimaging modalities in many hospitals, and the irradiation risk in childhood and its high cost.
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