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Children With Complex Febrile Seizures: Is Hospital Admission Necessary?

Nirupama Kannikeswaran1,2, Lalitha Sivaswamy1,2, Ahmad Farooqi1

  • 1Central Michigan University, Detroit, MI, USA.

Clinical Pediatrics
|May 20, 2021
PubMed

Insights

Hospitalizations for complex febrile seizures (CFS) in children rarely lead to diagnoses of serious bacterial infection (SBI) or seizure recurrence. Diagnostic studies and monitoring during hospitalization show low yield for these conditions in CFS patients.

Area of Science:

  • Pediatrics
  • Neurology
  • Infectious Diseases

Background:

  • Children with complex febrile seizures (CFS) are frequently hospitalized due to concerns for serious bacterial infection (SBI) or seizure recurrence.
  • Evaluating the necessity and yield of diagnostic evaluations and seizure monitoring during hospitalization for CFS is crucial.

Purpose of the Study:

  • To describe the diagnostic yield of studies and the incidence of seizure recurrence during hospitalization in children with CFS.
  • To identify predictors for seizure recurrence in this population.

Main Methods:

  • Retrospective review of 372 hospital visits in 350 developmentally normal children aged 6 to 60 months between 2011 and 2016.
  • Analysis of diagnostic study results for SBI and electroencephalography (EEG) findings.
  • Assessment of seizure recurrence during hospitalization.

Main Results:

  • The incidence of SBI was low, including bacteremia (1.1%), urinary tract infection (3.7%), pneumonia (6.8%), and no cases of bacterial meningitis.
  • Abnormal EEG findings were rare (4.4%).
  • Seizure recurrence during hospitalization occurred in only 5.1% of children, with no identified predictors.

Conclusions:

  • Hospitalization for CFS in otherwise healthy children has a low yield for diagnosing SBI.
  • Seizure recurrence during hospitalization and EEG abnormalities are uncommon in children with CFS.
  • Current hospitalization practices for CFS may warrant re-evaluation given the low incidence of serious findings.

Keywords:
childrencomplex febrile seizuresserious bacterial infections

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