Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Complex febrile convulsions: A clinical study

복합 열성 경련에 대한 임상적 고찰

  • Kang, Jeong Sik (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Sa-Ra (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Dong Wook (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Song, Tae Won (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Nam Hee (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Hwang, Jong Hee (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Moon, Jin Soo (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Chong Guk (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University)
  • 강정식 (인제대학교 의과대학 일산백병원 소아청소년과) ;
  • 김사라 (인제대학교 의과대학 일산백병원 소아청소년과) ;
  • 김동욱 (인제대학교 의과대학 일산백병원 소아청소년과) ;
  • 송태원 (인제대학교 의과대학 일산백병원 소아청소년과) ;
  • 김남희 (인제대학교 의과대학 일산백병원 소아청소년과) ;
  • 황종희 (인제대학교 의과대학 일산백병원 소아청소년과) ;
  • 문진수 (인제대학교 의과대학 일산백병원 소아청소년과) ;
  • 이종국 (인제대학교 의과대학 일산백병원 소아청소년과)
  • Received : 2008.04.01
  • Accepted : 2008.10.28
  • Published : 2009.01.15
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Abstract

Purpose : Febrile convulsions are classified into simple or complex types, the latter being characterized by increased risk of recurrence and progression to epilepsy. This study aimed to delineate the clinical characteristics of complex febrile convulsions. Methods : Between January 2003 and December 2006, 550 children were diagnosed with febrile convulsions at the Department of Pediatrics, Ilsan Paik Hospital. Their medical records were retrospectively reviewed for comparison between simple and complex febrile convulsions, and clinical findings of complex febrile convulsions were clarified. Results : Our subjects comprised a male-to-female ratio of 1.64:1; the age range was from 8 months to 8 years. Simple febrile convulsions comprised 432 cases, i.e., 4 times as many as complex febrile convulsions (118 cases). The causes of febrile illness included acute pharyngotonsillitis (357 cases, 64.9%), pneumonia (55 cases, 10.0%), acute gastroenteritis (37 cases, 6.7%), and otitis media (20 cases, 3.6%). We did not find any significant difference between simple and complex febrile convulsions in most clinical parameters such as gender, age, family history of febrile convulsions, and cause of febrile illness. Regarding subtypes of complex febrile convulsions, repeated convulsions were the most frequent (72.0%), followed by prolonged convulsions (16.9%) and focal convulsions (5.1%). Conclusion : We have reported here the clinical features of complex febrile convulsions. Although the results did not show any significant difference between simple and complex febrile convulsions in most clinical parameters such as gender, age, family history of febrile convulsion, and cause of febrile illness, further studies are essential to delineate complex febrile convulsions.

목 적 : 소아의 열성경련은 복합 열성 경련과 단순 열성 경련으로 나눌 수 있고, 복합형의 경우에는 열성 경련의 재발 및 간질로의 이행 가능성이 더 크다고 알려져 있는 바, 복합 열성 경련의 임상 양상에 대하여 조사 연구하였다. 방 법 : 2003년 1월부터 2006년 12월까지 열성 경련으로 일산백병원에 입원하였던 18세 이하의 비열성 경련의 경험이 없고 중추신경계 감염이나 다른 대사 이상 소견이 없으며 여러 가지 검사로도 경련의 원인이 밝혀지지 않은 열과 동반된 경련을 보인 소아 550명을 단순 및 복합 열성 경련군으로 구분하여 성별, 연령 분포, 발열 원인 질환, 가족력 등을 후향적으로 조사 분석하였고, 복합 열성 경련의 아형별 분류와 발생 빈도를 조사하였다. 결 과 : 남녀 비는 1.64:1이었고, 발작 당시 나이는 생후 8개월부터 8세 11개월까지 분포하였으며, 4세 미만이 485예(88.2%)로 대부분을 차지하였다. 단순 열성 경련이 432예, 복합 열성 경련이 118예로 단순열성 경련이 약 4배 많았으며, 각각의 남녀 비에는 차이가 없었다. 발열의 원인 질환으로는 급성 인후 편도염(357예, 64.9%), 폐렴(55예, 10%), 급성위장관염(37예, 6.7%), 중이염(20예, 3.6%) 등의 순이었으며, 단순 및 복합 열성 경련군 사이에 유의한 차이는 보이지 않았다. 과거력 및 가족력에서도 두 경련군 사이에 큰 차이는 없었다. 복합 열성 경련의 아형으로는, 반복성 경련(C2)이 72.0%로 가장 많았고, 지속성 경련(C1)과 국소성 경련(C3)이 각각 16.9%와 5.1%를 차지하였다. 결 론 : 열성 경련의 유형에 따른 남녀비와 원인 질환, 가족력에 있어서 유의한 차이는 없었다. 열성 경련은 대부분의 경우에 있어서 후유증을 남기지 않는 예후가 양호한 질환으로 알려져 있지만 열에 의해서 유발된 간질 발작의 기본형으로 보는 견해도 있고, 환자들 중 일부는 후에 간질로 진행하기도 하기 때문에 단순과 복합 열성 경련에 대한 더 큰 규모의 연구가 필요할 것으로 생각된다.

Keywords

Acknowledgement

Supported by : Inje University

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