Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A comparison of provoked seizures and febrile seizures associated with minor infections

경미한 감염과 관련된 유발성 경련과 열성 경련의 비교

  • Lee, Eun-Ju (Department of Pediatrics, College of Medicine and Medical Research Institute, Chungbuk National University) ;
  • Kim, Won Seop (Department of Pediatrics, College of Medicine and Medical Research Institute, Chungbuk National University)
  • 이은주 (충북대학교 의과대학 소아과학교실) ;
  • 김원섭 (충북대학교 의과대학 소아과학교실)
  • Received : 2007.02.26
  • Accepted : 2007.03.15
  • Published : 2007.04.15
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Abstract

Purpose : Febrile seizures occur in childhood associated with a febrile illness not caused by infections of the central nervous system. Provoked seizures are identified with seizures in association with infections that do not usually affect the brain such as gastroenteritis, except criteria for other febrile seizures in this study. We studied seizures provoked by minor extracranial infections, to contrast them with febrile and provoked seizures. Methods : We retrospectively studied one hundred and twenty children with provoked and febrile seizures who visited Chungbuk National University hospital from January, 2000 to December, 2004. Among these children, 36 patients were determined as provoked seizures and 84 patients as febrile seizures. We compared the distribution of minor infections between the patients with provoked seizures and those with febrile seizures, and studied risk factors of subsequent unprovoked seizures after febrile and provoked seizures associated with minor infections. Results : We analyzed the records of 120 children aged from 1 month to 15 years. The common etiologies of minor infections were gastroenteritis and respiratory infections. In the group of febrile seizures, there was a significantly greater proportion of patients with respiratory infections (58.3%) and a lesser proportion of those with gastroenteritis (25.0%). But there was a higher incidence of gastroenteritis (50.0%) in the provoked group. Comparing the distribution of etiologies between the patients with provoked seizures and those with febrile seizures seemed a significant difference. But, there were no difference between the provoked seizures and febrile seizures in the risk for subsequent unprovoked seizures. Conclusion : In conclusion, the leading cause except brain involvement is gastroenteritis in patients with provoked seizures, and respiratory infection in those with febrile seizures. Thus we need prompt recognition of, and medical attention given to, seizures associated with minor infections.

목 적 : 중추 신경계를 제외한 기타 경미한 감염의 경우에 유발성 경련 및 열성 경련과의 연관성에 대해 조사하였고, 또한 이러한 경련 환아들을 추적해 보았을 때 비유발성 경련으로의 발현과는 어떠한 관련성을 보이는가에 관해 통계적으로 분석하고자 하였다. 방 법 : 첫 경련을 주소로 내원한 환아 중에서 중추 신경계에 관련된 감염을 제외한 경미한 감염을 원인으로 하는 경우를 대상으로 하였고, 이를 유발성 경련과 열성 경련으로 구분하여 이에 따른 원인별 비교 및 역학적 조사를 실시하였다. 또한 이러한 유발성 경련과 열성 경련 환아를 대상으로 1년 이상의 추적 관찰을 시행하여 비유발성 경련으로의 이행 여부를 조사하고 통계 분석을 실시하였다. 결 과 : 총 120명의 환아들 중에서 유발성 경련은 36명, 열성 경련은 84명이었고, 여러 원인들 가운데 위장관염과 호흡기계 감염이 대부분을 차지하여 두 원인 군에 따른 비교 분석을 시행하였다. 유발성 경련의 경우는 위장관염이 가장 많은 원인을 차지하였고, 열성 경련의 경우는 호흡기계 감염이 많은 원인을 차지하였으며 이러한 경미한 감염원인 인자들과 경련과의 분포 차이는 통계적으로 유의하게 나타났다. 그러나 경련에 따른 비유발성 경련으로의 이행의 차이는 통계적으로 유의하지 않은 것으로 나타나 향후 보다 장기적인 추적관찰이 시행되어져야 할 것으로 사료된다. 결 론 : 소아에서 감염에 관련된 이러한 경련의 경우는 중추 신경계에 관련된 경우보다 경련에 대한 주의와 신속한 대처가 상대적으로 미흡했다고 볼 수 있다. 그러나 앞으로는 이러한 경미한 감염이 있는 경우에도 세심한 관찰과 주의가 필요하다고 보여지며 향후 비유발성 경련 발현에 대한 지속적인 추적관찰이 필요하다고 생각된다.

Keywords

Acknowledgement

Supported by : 충북대학교

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