Aggiornamento monografico
Le convulsioni febbrili
FEBRILE SEIZURES
PAOLA COSTA1, FEDERICO MARCHETTI2
1Unità Operativa di Neuropsichiatria Infantile, IRCCS “Burlo Garofolo”, Trieste
2Clinica Pediatrica, IRCCS “Burlo Garofolo”, Università di Trieste
Aprile 2005 - pagg. 227 -234
Abstract
Febrile seizures (FS) is the most common seizures in childhood (2-4%). The diagnostic evaluation
of the child with a FS can be very limited or moderately comprehensive. The primary
concern is always the need to exclude meningitis. Recurrences are common, but only a small
minority will go to develop epilepsy. The association between FS and temporal lobe epilepsy
probably results from complex interactions between several genetic and environmental factors.
There are several syndrome-specific genes for febrile seizures. Prophylactic antipyretic
and anticonvulsant therapies are not recommended. Use of rectal diazepam at home in case
of convulsion is useful. The parents should be counselled about the benign nature of the FS.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Freeman JM. Febrile seizures: a consensus
of their significance, evaluation, and treatment.
Consensus development conference of
febrile seizures. 1980. National Institute of
Health. Pediatrics 1980;66:1009-12.
2. Joint Working Group of the research Unit of the Royal College of Physicians and the British Paediatric Association: Guidelines for the management of convulsions with fever. BMJ 1991;303:634-6.
3. AA.VV. Il bambino con convulsioni febbrili. Medico e Bambino 1991:6:26-31.
4. Camfield P, Camfield C, Kurlemann G. Febrile Seizures. In: Epileptic Syndrome in Infancy, Childhood and Adolescence. J Roger, M Bureau, Ch Dravet, P Genton, C.A. Tassinari e P Wolf John Libbey e Co Ltd 2002; Pag:145-52.
5. Ellenberg JH, Nelson KB. Febrile seizures and later intellectual performance. Arch Neurol 1978;35:17-21.
6. Verity CM, Greenwood R, Golding J. Longterm intellectual and behavioural outcome of children with febrile convulsions. N Engl J Med 1998;338:1723-38.
7. Arzimanoglou A, Guerrini R, Aicardi J. Febrile Convulsions. In: Aicardi’s Epilepsy in Children. Lippincott Williams e Wilkins, 2004.
8. Engel J Jr. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE task force on classification and terminology. Epilepsia 2001;42: 796-803.
9. Waruiru C, Appleton R. Febrile Seizures: an update. Arch Dis Child 2004;89:751-6.
10. AAP. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. American Academy of Pediatrics. Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics 1996;97:769-75.
11. Jensen FE, Sanchez RM. Why does the developing brain demonstrate heightened susceptibility to febrile and other provoked seizures. In: Baram TZ, Shinnar S, (eds.) Febrile seizures. San Diego: Academic Press, 2002: 153-68.
12. Berg AT. Are febrile seizures provoked by a rapid rise in temperature. Am J Dis Child 1993;147:1101-3.
13. Minchom PE, Wallace S. Febrile convulsions: electroencephalograph changes related to rectal temperature. Arch Dis Child 1984;59: 371-3.
14. Berg AT, Shinnar S. Complex febrile seizures. Epilepsia 1996;37:126-33.
15. Schnaidermann D, Lahat E, Sheefer T, Adjalem M. Antipyretic effectiveness of acetaminophen in febrile seizures: ongoing prophylaxis versus sporadic usage. Eur J Pediatr 1993;152:747-9.
16. Uhari M, Rantala H, Vainionpää L, Kurttila R. Effect of acetaminophen and of low intermittent doses of diazepam on prevention of recurrences of febrile seizures. J Pediatr 1995; 126:991-5.
17. Van Stuijvenberg M, Derksen-Lubsen G, Steyerberg EW, Habbema JD, Moll HA. Randomized, controlled trial of ibuprofen syrup administered during febrile illnesses to prevent febrile seizure recurrences. Pediatrics 1998;102(5):e51.
18. El-Radhi AS, Barry W. Do antipyretics prevent febrile convulsions? Arch Dis Child 2003; 88(7):641-2.
19. Gatti S, Vezzani A, Bartfai T. Mechanisms of fever and febrile seizures: putative role of the interleukin-1 system. In: Baram TZ, Shinnar S, (eds.) Febrile seizures. San Diego: Academic Press, 2002;169-88.
20. Virta M, Hurme M, Helminen M. Increased plasma levels of pro- and anti-inflammatory cytokines in patients with febrile seizures. Epilepsia 2002;43:920–3.
21. Haspolat S, Mihci E, Coskum M, et al. Interleukin- 1beta, tumour necrosis factor-alpha, and nitrite levels in febrile seizures. J Child Neurol 2002;17:749–51.
22. Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures Pediatrics 1978; 61:720-7.
23. Maytal J, Shinnar S. Febrile status epilepticus. Pediatrics 1990;86:611–6.
24. Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976;295:1029-33.
25. Verity CM, Butler NR, Golding J. Febrile convulsions in a national cohort followed up from birth. I-prevalence and recurrence in the first five years of life. BMJ 1985;290:1307-10.
26. Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia 1994;35(suppl 2):S1–6.
27. Forsgren L, Sidenvall R, Blomquist HK, et al. A prospective incidence study of febrile convulsions. Acta Paediatr Scand 1990;79:550-7.
28. Van Esch A, Steyerberg EW, Van Duijn CM, et al. Prediction of febrile seizures in siblings: a practical approach. Neuropediatrics 1998;157:340-4.
29. Bethune P, Gordon K, Dooley J, et al. Which child will have a febrile seizure. Am J Dis Child 1993;147:35-9.
30. Offringa M, Bossuyt PMM, Lubsen J, et al. Risk factors for seizure recurrence in children with febrile seizures: a pooled analysis of individual patient data from five studies. J Pediatr 1994;124:574-84.
31. Fukuyama Y, Kagawa K, Tanaka K. A genetic study of febrile convulsions. Eur Neurol 1979;18:166-82.
32. Tsuboi T, Okada S. Exogenous causes of seizures in children: a population study. Acta Neurol Scand 1985;1:107-13.
33. Baulac S, Gourfinkel-An I, Picard F, et al. A second locus for familial generalized epilepsy with febrile plus maps to chromosome 2q21–q33. Am J Hum Genet 1999;65:1078-85.
34. Nakayama J, Hamano K, Iwaski N, et al. Significant evidence for linkage of febrile seizures to chromosome 5q14–q15. Hum Mol Genet 2000;9:87-91.
35. Wallace RH, Scheffer IE, Barnett S, et al. Neuronal sodium-channel alpha1-subunit mutations in generalized epilepsy with febrile seizures plus. Am J Hum Genet 2001;68:859-65.
36. Wallace RH, Berkovic SF, Howell RA, et al. Suggestion of a major gene for familial febrile convulsions mapping to 8q13-21. J Med Genet 1996;33:308-12.
37. Johnson EW, Dubovsky J, Rich SS, et al. Evidence for a novel gene for familial febrile convulsions, FEB2, linked to chromosome 19p in an extended family from the Midwest. Hum Mol Genet 1998;7:63-7.
38. Wallace RH, Wang DW, Singh R, et al. Febrile seizures and generalized epilepsy associated with a mutation in the Na+-channel beta 1 subunit gene SCN1B. Nat Genet 1998; 19:366-70.
39. Singh R, Scheffer IE, Crossland K, et al. Generalized epilepsy with febrile seizures plus: a common childhood-onset genetic epilepsy syndrome. Ann Neurol 1999;45:75-81.
40. Scheffer IE, Berkovic SF. Generalised epilepsy with febrile seizures plus: a genetic disorder with heterogeneous clinical phenotypes. Brain 1997;120:479-90.
41. Hall CB, Long CE, Schnabel KC, et al. Human herpesvirus-6 infection in children. N Engl J Med 1994;331:432-8.
42. Berg AT, Shinnar S, Darefsky AS, et al. Predictors of recurrent febrile seizures. Arch Pediatr Adolesc Med 1997;151:371-8.
43. Berg AT, Shinnar S, Hauser WA, et al. A prospective study of recurrent febrile seizures. N Engl J Med 1992;327:1122-7.
44. Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976;295:1029-33.
45. Al-Eissa YA. Febrile seizures: rate and risk factors of recurrence. J Child Neurol 1995; 10:315-9.
46. Berg AT, Shinnar S, Hauser WA, et al. Predictors of recurrent febrile seizures: a metaanalytic review. J Pediatr 1990;116:329-37.
47. Knudsen FU. Recurrence risk after a first febrile seizure and effect of short-term diazepam prophylaxis. Arch Dis Child 1985;60: 1045-9.
48. Rantala H, Uhari M. Risk factor for recurrence of febrile convulsions. Acta Neurol Scand 1994; 90:207-10.
49. El-Radhi AS, Withana K, Banajeh S. Recurrence rate of febrile convulsion related to the degree of pyrexia during the first attack. Clin Pediatr 1986;25:311-3.
50. Annegers JF, Hauser WA, Shirto SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316:493-8.
51. Verity CM, Golding J. Risk of epilepsy after febrile convulsions: a national cohort study. BMJ 1991;303:1373-6.
52. Camfield P, Camfield C, Gordon K, Dooley J. What types of epilepsy are preceded by febrile seizures? Dev Med Child Neurol 1994; 36:889-92.
53. Hamati-Haddad a, Abou Khalil b. Epilepsy diagnosis and localization in patient with antecedents of febrile convulsions. Neurology 1998;50:917-22.
54. Baulac S, Gourfinkel-An I, Nabbout R, et al. Fever, genes and epilepsy. Lancet Neurol 2004;3:421-30.
55. Trinka E, Unterrainer J, Haberlandt UE, et al. Childhood febrile convulsions - which factors determine the subsequent epilepsy syndrome? A retrospective study. Epilepsy Res 2002;50:283-92.
56. Falconer MA, Serafetinides EA, Corsellis JA. Aetiology and pathogenesis of temporal lobe epilepsy. Arch Neurol 1964;10:233-48.
57. Cendes F, Andermann F, Dubeau F, et al. Early childhood prolonged febrile convulsions, atrophy and sclerosis of mesial structures, and temporal lobe epilepsy: an MRI volumetric study. Neurology 1993;43:1083-7.
58. Abou-khalil B, Andermann E, Olivier A, et al. Temporal lobe epilepsy after prolonged febrile convulsions: excellent outcome after surgical treatment. Epilepsia 1993;34:878-8.
59. French JA, Williamson PD, Thadani VM. Characteristics of medial temporal lobe epilepsy: I. Results of history and physical examination. Ann Neurol 1993;34:774-80.
60. Scott RC, Gadian DG, King MD, et al. Magnetic resonance imaging findings within 5 days of status epilepticus in childhood. Brain 2002;125:1951-9.
61. Scott RC, King MD, Gadian DG, et al. Hippocampal abnormalities after prolonged febrile convulsion: a longitudinal MRI study. Brain 2003;126:2551-7.
62. Kuks JBM, Cook MJ, Stevens JM, et al. Hippocampal sclerosis in epilepsy and childhood febrile seizures. Lancet 1993; 342:1391-4.
63. Tarkka R, Paakko E, Phytinen J, et al. Febrile seizures and mesial temporal sclerosis: no association in a long-term follow-up study. Neurology 2003;60:215-8.
64. Porter BE, Judkins AR, Clancy RR, et al. Dysplasia: a common finding in intractable paediatric temporal lobe epilepsy. Neurology 2003;61:365-8.
65. Dube C, Chen K, Eghbal-Ahmadi M, et al. Prolonged febrile seizures in the immature rat model enhance hippocampal excitability long term. Ann Neurol 2000;47:336-44.
66. Kanemoto K, Kawasaki J, Yuasa s, et al. Increased frequency of interleukin-1beta-511T allele in patients with temporal lobe epilepsy, hippocampal sclerosis, and prolonged febrile convulsion. Epilepsia 2003;44(6):796-9.
67. Maytal J, Steekle R, Eviatar L, Novak G. The value of early post-critical EEG in Children with complex febrile seizures. Epilepsia 2000;41(2):219-221.
68. Cuestas E. Is routine EEG helpful in the management of complex febrile seizures? Arch Dis Child 2004;89(3):290.
69. Ventura A, Basso T, Bortolan G, et al. Home treatment of seizures as a strategy for the long term management of febrile convulsions in children. Helv Ped Acta 1982;37:581-7.
70. Appleton R, Martland T, Phillips B Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children. Cochrane Database Syst Rev 2002;(4):CD001905.
71. Appleton R, Choonara I, Martland T, Phillips B, Scott R, Whitehouse W. The Status Epilepticus Working Party, Members of the Status Epilepticus Working Party. Arch Dis Child 2000;83:415-9.
72. Marchetti F, Bonati M. Convulsioni febbrili: quali novità? Medico e Bambino 1995;2:87-9.
73. Autret E, Billard C, Bertrand P, Motte J, Pouplard F, Jonville AP. Double-blind, randomized trial of diazepam versus placebo for prevention of recurrence of febrile seizures. J Pediatr 1990;117(3):490-4.
74. Rosman NP, Colton T, Labazzo J, et al. A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures. N Engl J Med 1993;329:79-84.
75. Verrotti A, Latini G, di Corcia G, et al. Intermittent oral diazepam prophylaxis in febrile convulsions: its effectiveness for febrile seizure recurrence. Eur J Paediatr Neurol 2004; 8(3):131-4.
76. Knudsen FU, Vestermark S. Prophylactic diazepam or phenobarbitone in febrile convulsions: a prospective, controlled study. Arch Dis Child 1978;53:660-3.
77. Knudsen FU. Effective short-term diazepam prophylaxis in febrile convulsions. J Pediatr 1985;106:487-90.
78. Newton RW. Randomised controlled trials of phenobarbitone and valproate in febrile convulsions. Arch Dis Child 1988;63:1189–91.
79. Rantala H, Tarkka R, Uhari M. A metaanalytic review of the preventive treatment of recurrences of febrile seizures. J Pediatr 1997; 131:922-5.
80. van Stuijvenberg M, de Vos S, Tjiang GC, et al. Parents’ fear regarding fever and febrile seizures. Acta Paediatr 1999;88:618-22.
81. Parmar RC, Sahu DR, Bavdekar SB. Knowledge, attitude and practices of parents of children with febrile convulsion. J Postgrad Med 2001;47(1):19-23.
82. Marchetti F. EBM e informazione ai genitori di bambini affetti da convulsioni febbrili. Quaderni acp 2001;2:35.
2. Joint Working Group of the research Unit of the Royal College of Physicians and the British Paediatric Association: Guidelines for the management of convulsions with fever. BMJ 1991;303:634-6.
3. AA.VV. Il bambino con convulsioni febbrili. Medico e Bambino 1991:6:26-31.
4. Camfield P, Camfield C, Kurlemann G. Febrile Seizures. In: Epileptic Syndrome in Infancy, Childhood and Adolescence. J Roger, M Bureau, Ch Dravet, P Genton, C.A. Tassinari e P Wolf John Libbey e Co Ltd 2002; Pag:145-52.
5. Ellenberg JH, Nelson KB. Febrile seizures and later intellectual performance. Arch Neurol 1978;35:17-21.
6. Verity CM, Greenwood R, Golding J. Longterm intellectual and behavioural outcome of children with febrile convulsions. N Engl J Med 1998;338:1723-38.
7. Arzimanoglou A, Guerrini R, Aicardi J. Febrile Convulsions. In: Aicardi’s Epilepsy in Children. Lippincott Williams e Wilkins, 2004.
8. Engel J Jr. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE task force on classification and terminology. Epilepsia 2001;42: 796-803.
9. Waruiru C, Appleton R. Febrile Seizures: an update. Arch Dis Child 2004;89:751-6.
10. AAP. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. American Academy of Pediatrics. Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics 1996;97:769-75.
11. Jensen FE, Sanchez RM. Why does the developing brain demonstrate heightened susceptibility to febrile and other provoked seizures. In: Baram TZ, Shinnar S, (eds.) Febrile seizures. San Diego: Academic Press, 2002: 153-68.
12. Berg AT. Are febrile seizures provoked by a rapid rise in temperature. Am J Dis Child 1993;147:1101-3.
13. Minchom PE, Wallace S. Febrile convulsions: electroencephalograph changes related to rectal temperature. Arch Dis Child 1984;59: 371-3.
14. Berg AT, Shinnar S. Complex febrile seizures. Epilepsia 1996;37:126-33.
15. Schnaidermann D, Lahat E, Sheefer T, Adjalem M. Antipyretic effectiveness of acetaminophen in febrile seizures: ongoing prophylaxis versus sporadic usage. Eur J Pediatr 1993;152:747-9.
16. Uhari M, Rantala H, Vainionpää L, Kurttila R. Effect of acetaminophen and of low intermittent doses of diazepam on prevention of recurrences of febrile seizures. J Pediatr 1995; 126:991-5.
17. Van Stuijvenberg M, Derksen-Lubsen G, Steyerberg EW, Habbema JD, Moll HA. Randomized, controlled trial of ibuprofen syrup administered during febrile illnesses to prevent febrile seizure recurrences. Pediatrics 1998;102(5):e51.
18. El-Radhi AS, Barry W. Do antipyretics prevent febrile convulsions? Arch Dis Child 2003; 88(7):641-2.
19. Gatti S, Vezzani A, Bartfai T. Mechanisms of fever and febrile seizures: putative role of the interleukin-1 system. In: Baram TZ, Shinnar S, (eds.) Febrile seizures. San Diego: Academic Press, 2002;169-88.
20. Virta M, Hurme M, Helminen M. Increased plasma levels of pro- and anti-inflammatory cytokines in patients with febrile seizures. Epilepsia 2002;43:920–3.
21. Haspolat S, Mihci E, Coskum M, et al. Interleukin- 1beta, tumour necrosis factor-alpha, and nitrite levels in febrile seizures. J Child Neurol 2002;17:749–51.
22. Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures Pediatrics 1978; 61:720-7.
23. Maytal J, Shinnar S. Febrile status epilepticus. Pediatrics 1990;86:611–6.
24. Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976;295:1029-33.
25. Verity CM, Butler NR, Golding J. Febrile convulsions in a national cohort followed up from birth. I-prevalence and recurrence in the first five years of life. BMJ 1985;290:1307-10.
26. Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia 1994;35(suppl 2):S1–6.
27. Forsgren L, Sidenvall R, Blomquist HK, et al. A prospective incidence study of febrile convulsions. Acta Paediatr Scand 1990;79:550-7.
28. Van Esch A, Steyerberg EW, Van Duijn CM, et al. Prediction of febrile seizures in siblings: a practical approach. Neuropediatrics 1998;157:340-4.
29. Bethune P, Gordon K, Dooley J, et al. Which child will have a febrile seizure. Am J Dis Child 1993;147:35-9.
30. Offringa M, Bossuyt PMM, Lubsen J, et al. Risk factors for seizure recurrence in children with febrile seizures: a pooled analysis of individual patient data from five studies. J Pediatr 1994;124:574-84.
31. Fukuyama Y, Kagawa K, Tanaka K. A genetic study of febrile convulsions. Eur Neurol 1979;18:166-82.
32. Tsuboi T, Okada S. Exogenous causes of seizures in children: a population study. Acta Neurol Scand 1985;1:107-13.
33. Baulac S, Gourfinkel-An I, Picard F, et al. A second locus for familial generalized epilepsy with febrile plus maps to chromosome 2q21–q33. Am J Hum Genet 1999;65:1078-85.
34. Nakayama J, Hamano K, Iwaski N, et al. Significant evidence for linkage of febrile seizures to chromosome 5q14–q15. Hum Mol Genet 2000;9:87-91.
35. Wallace RH, Scheffer IE, Barnett S, et al. Neuronal sodium-channel alpha1-subunit mutations in generalized epilepsy with febrile seizures plus. Am J Hum Genet 2001;68:859-65.
36. Wallace RH, Berkovic SF, Howell RA, et al. Suggestion of a major gene for familial febrile convulsions mapping to 8q13-21. J Med Genet 1996;33:308-12.
37. Johnson EW, Dubovsky J, Rich SS, et al. Evidence for a novel gene for familial febrile convulsions, FEB2, linked to chromosome 19p in an extended family from the Midwest. Hum Mol Genet 1998;7:63-7.
38. Wallace RH, Wang DW, Singh R, et al. Febrile seizures and generalized epilepsy associated with a mutation in the Na+-channel beta 1 subunit gene SCN1B. Nat Genet 1998; 19:366-70.
39. Singh R, Scheffer IE, Crossland K, et al. Generalized epilepsy with febrile seizures plus: a common childhood-onset genetic epilepsy syndrome. Ann Neurol 1999;45:75-81.
40. Scheffer IE, Berkovic SF. Generalised epilepsy with febrile seizures plus: a genetic disorder with heterogeneous clinical phenotypes. Brain 1997;120:479-90.
41. Hall CB, Long CE, Schnabel KC, et al. Human herpesvirus-6 infection in children. N Engl J Med 1994;331:432-8.
42. Berg AT, Shinnar S, Darefsky AS, et al. Predictors of recurrent febrile seizures. Arch Pediatr Adolesc Med 1997;151:371-8.
43. Berg AT, Shinnar S, Hauser WA, et al. A prospective study of recurrent febrile seizures. N Engl J Med 1992;327:1122-7.
44. Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976;295:1029-33.
45. Al-Eissa YA. Febrile seizures: rate and risk factors of recurrence. J Child Neurol 1995; 10:315-9.
46. Berg AT, Shinnar S, Hauser WA, et al. Predictors of recurrent febrile seizures: a metaanalytic review. J Pediatr 1990;116:329-37.
47. Knudsen FU. Recurrence risk after a first febrile seizure and effect of short-term diazepam prophylaxis. Arch Dis Child 1985;60: 1045-9.
48. Rantala H, Uhari M. Risk factor for recurrence of febrile convulsions. Acta Neurol Scand 1994; 90:207-10.
49. El-Radhi AS, Withana K, Banajeh S. Recurrence rate of febrile convulsion related to the degree of pyrexia during the first attack. Clin Pediatr 1986;25:311-3.
50. Annegers JF, Hauser WA, Shirto SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316:493-8.
51. Verity CM, Golding J. Risk of epilepsy after febrile convulsions: a national cohort study. BMJ 1991;303:1373-6.
52. Camfield P, Camfield C, Gordon K, Dooley J. What types of epilepsy are preceded by febrile seizures? Dev Med Child Neurol 1994; 36:889-92.
53. Hamati-Haddad a, Abou Khalil b. Epilepsy diagnosis and localization in patient with antecedents of febrile convulsions. Neurology 1998;50:917-22.
54. Baulac S, Gourfinkel-An I, Nabbout R, et al. Fever, genes and epilepsy. Lancet Neurol 2004;3:421-30.
55. Trinka E, Unterrainer J, Haberlandt UE, et al. Childhood febrile convulsions - which factors determine the subsequent epilepsy syndrome? A retrospective study. Epilepsy Res 2002;50:283-92.
56. Falconer MA, Serafetinides EA, Corsellis JA. Aetiology and pathogenesis of temporal lobe epilepsy. Arch Neurol 1964;10:233-48.
57. Cendes F, Andermann F, Dubeau F, et al. Early childhood prolonged febrile convulsions, atrophy and sclerosis of mesial structures, and temporal lobe epilepsy: an MRI volumetric study. Neurology 1993;43:1083-7.
58. Abou-khalil B, Andermann E, Olivier A, et al. Temporal lobe epilepsy after prolonged febrile convulsions: excellent outcome after surgical treatment. Epilepsia 1993;34:878-8.
59. French JA, Williamson PD, Thadani VM. Characteristics of medial temporal lobe epilepsy: I. Results of history and physical examination. Ann Neurol 1993;34:774-80.
60. Scott RC, Gadian DG, King MD, et al. Magnetic resonance imaging findings within 5 days of status epilepticus in childhood. Brain 2002;125:1951-9.
61. Scott RC, King MD, Gadian DG, et al. Hippocampal abnormalities after prolonged febrile convulsion: a longitudinal MRI study. Brain 2003;126:2551-7.
62. Kuks JBM, Cook MJ, Stevens JM, et al. Hippocampal sclerosis in epilepsy and childhood febrile seizures. Lancet 1993; 342:1391-4.
63. Tarkka R, Paakko E, Phytinen J, et al. Febrile seizures and mesial temporal sclerosis: no association in a long-term follow-up study. Neurology 2003;60:215-8.
64. Porter BE, Judkins AR, Clancy RR, et al. Dysplasia: a common finding in intractable paediatric temporal lobe epilepsy. Neurology 2003;61:365-8.
65. Dube C, Chen K, Eghbal-Ahmadi M, et al. Prolonged febrile seizures in the immature rat model enhance hippocampal excitability long term. Ann Neurol 2000;47:336-44.
66. Kanemoto K, Kawasaki J, Yuasa s, et al. Increased frequency of interleukin-1beta-511T allele in patients with temporal lobe epilepsy, hippocampal sclerosis, and prolonged febrile convulsion. Epilepsia 2003;44(6):796-9.
67. Maytal J, Steekle R, Eviatar L, Novak G. The value of early post-critical EEG in Children with complex febrile seizures. Epilepsia 2000;41(2):219-221.
68. Cuestas E. Is routine EEG helpful in the management of complex febrile seizures? Arch Dis Child 2004;89(3):290.
69. Ventura A, Basso T, Bortolan G, et al. Home treatment of seizures as a strategy for the long term management of febrile convulsions in children. Helv Ped Acta 1982;37:581-7.
70. Appleton R, Martland T, Phillips B Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children. Cochrane Database Syst Rev 2002;(4):CD001905.
71. Appleton R, Choonara I, Martland T, Phillips B, Scott R, Whitehouse W. The Status Epilepticus Working Party, Members of the Status Epilepticus Working Party. Arch Dis Child 2000;83:415-9.
72. Marchetti F, Bonati M. Convulsioni febbrili: quali novità? Medico e Bambino 1995;2:87-9.
73. Autret E, Billard C, Bertrand P, Motte J, Pouplard F, Jonville AP. Double-blind, randomized trial of diazepam versus placebo for prevention of recurrence of febrile seizures. J Pediatr 1990;117(3):490-4.
74. Rosman NP, Colton T, Labazzo J, et al. A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures. N Engl J Med 1993;329:79-84.
75. Verrotti A, Latini G, di Corcia G, et al. Intermittent oral diazepam prophylaxis in febrile convulsions: its effectiveness for febrile seizure recurrence. Eur J Paediatr Neurol 2004; 8(3):131-4.
76. Knudsen FU, Vestermark S. Prophylactic diazepam or phenobarbitone in febrile convulsions: a prospective, controlled study. Arch Dis Child 1978;53:660-3.
77. Knudsen FU. Effective short-term diazepam prophylaxis in febrile convulsions. J Pediatr 1985;106:487-90.
78. Newton RW. Randomised controlled trials of phenobarbitone and valproate in febrile convulsions. Arch Dis Child 1988;63:1189–91.
79. Rantala H, Tarkka R, Uhari M. A metaanalytic review of the preventive treatment of recurrences of febrile seizures. J Pediatr 1997; 131:922-5.
80. van Stuijvenberg M, de Vos S, Tjiang GC, et al. Parents’ fear regarding fever and febrile seizures. Acta Paediatr 1999;88:618-22.
81. Parmar RC, Sahu DR, Bavdekar SB. Knowledge, attitude and practices of parents of children with febrile convulsion. J Postgrad Med 2001;47(1):19-23.
82. Marchetti F. EBM e informazione ai genitori di bambini affetti da convulsioni febbrili. Quaderni acp 2001;2:35.