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Clinical investigation of infantile convulsion
Insights
Infantile convulsions in infants under two years old, without brain disorders, often resolve by age two. Risk factors include family history and perinatal anoxic brain damage, with generalized tonic-clonic seizures being most common.
Area of Science:
- Pediatrics
- Neurology
- Child Health
Background:
- Infantile convulsions are common in early childhood.
- Understanding risk factors and outcomes is crucial for early intervention.
- Distinguishing benign from severe cases is essential.
Purpose of the Study:
- To investigate the characteristics of infantile convulsions in children under two years.
- To identify risk factors and precipitating events.
- To determine the long-term outcomes, including the risk of epilepsy.
Main Methods:
- Retrospective analysis of 104 cases of infantile convulsions.
- Inclusion criteria: onset before two years, no acute brain disorders, normal development and EEG at onset.
- Prospective follow-up for outcome assessment.
Main Results:
- No significant sex difference (1:1 ratio).
- Positive family history in 30.8%; febrile convulsions in 65.7%.
- Increased incidence of perinatal anoxic brain damage.
- Most first seizures (66.3%) occurred between 3-8 months.
- 95.6% seizure-free by two years.
- Precipitating factors (bathing, infection) in 45.1%.
- Generalized tonic-clonic seizures (78.8%) lasting <5 min (82.7%) were most common.
- Higher epilepsy risk noted for early onset (3-5 months), frequent (>6) or prolonged seizures.
Conclusions:
- Infantile convulsions in this cohort were generally benign, with most infants outgrowing them by age two.
- Family history and perinatal factors are associated with infantile convulsions.
- Specific seizure characteristics (early onset, frequency, duration) may predict later epilepsy development.
Abstract:
We investigated 104 cases of infantile convulsions which occurred before two years of age. These cases had no detectable signs of acute brain disorders, and they had normal psychomotor development and normal EEG findings at onset. (1) Sex ratio was 1:1. (2) A positive family history of various types of convulsions was obtained in 30.8% (Febrile convulsion: 65.7%) (3) The incidence of perinatal anoxic brain damage was higher than that in the control group. This was probably related to the incidence of infantile convulsion. (4) More than half the cases (66.3%) had the first convulsion between three and eight months of age, and 95.6% of prospectively follow-up cases were shown free from attacks before two years of age. (5) Precipitating factors to convulsion were found in 45.1% of all cases. These factors were bathing and non-febrile infection. (6) The most common form of infantile convulsion is generalized tonic and/or clonic convulsion (78.8%) within 5 min. (82.7%). This convulsion reccurs frequently in a relatively short period. (7) The incidence of subsequent epilepsy seems to have been found among patients who had had an initial attack between three and five months of age, and had then experienced convulsion more than six times or in a prolonged state.