Epidemiology and characteristics of febrile seizures in children

peer reviewedRésumé : Les convulsions fébriles (CF), malgré leur bénignité, font toujours l’objet de discussions concernant les investigations à entreprendre et l’attitude thérapeutique à adopter. Notre étude vise à faire l’inventaire des éléments cliniques et paracliniques présents lors de survenue des CF et susceptibles d’en influencer la prise en charge. 275 épisodes de CF admis aux Urgences Pédiatriques du CHR sur une période de 5 ans ont été analysés rétrospectivement sur la base des circonstances de survenue, des caractéristiques cliniques, des examens paracliniques et de la prise en charge immédiate. Les CF représentent 1,4% des admissions pédiatriques. Un antécédent familial a pu être retrouvé dans 31,3 % des épisodes. 9% des crises étaient latéralisées, 11,7% étaient répétitives et 12,3% ont duré plus de 10 minutes. Les infections des voies respiratoires supérieures et otorhinolaryngologiques d’origine virale étaient les plus incriminées: 69,5%. Les explorations paracliniques étaient normales dans plus de 90 % des cas. L’évolution était spontanément favorable dans 73,8% des cas. Un anticonvulsivant a été nécessaire pour les 26,2 % restants. Notre travail confirme le caractère bénin de la majorité des CF et leur évolution favorable. La réalisation des examens complémentaires et l’indication d’un traitement antiépileptique doit reposer principalement sur l’analyse des signes de gravité.Summary : Febrile Seizures (FS), despite their usual benign clinical course, are still subject of controversies regarding the need for further investigation and treatment with anti-epileptic drugs (AEDs). Our study aimed to inventory the clinical findings, laboratory and imaging data associated with FS and eventually influencing their management. 275 episodes admitted with FS at the emergency ward of the Liège CHR over a 5 year period were retrospectively analyzed regarding precipitating factors; clinical features; laboratory, electroencephalographic, and imaging studies; as well as treatment response. FS represented 1.4% of admissions to the pediatric service. 31.3% of patients had a family history of seizure disorder. 9% percent of seizures were focal, 11.7% recurrent, and 12.3% prolonged (greater than 10 minutes). Upper respiratory tract and otorhinolaryngologic viral infections were the most often implicated provoking factors, occurring in 69.5% of patients. Laboratory, electroencephalographic and radiographic studies were normal in more than 90% of cases. 73.8% of seizures resolved without intervention. An AED was required to manage the remaining 26.2%. This study confirms the favorable outcomes of FS as demonstrated in previous studies. This happens without requiring AEDs for resolution, and without recurrence. Laboratory, electroencephalographic and imaging studies, as well as initiation of AEDs should be based primarily on clinical severity

Update on the management of bronchiolitis

peer reviewedBronchiolitis is one of the main reasons for hospitalization, or outpatient visits, in the paediatric population, especially among infants in the winter season. Despite the high incidence of the disease, ideal medical work up and treatment are still a matter of debate in the literature and among physicians. However, the most recent guidelines and review of literature do agree on some points. These agreements can be retained and used to improve the treatment of bronchiolitis in our setting