Febrile seizure management and effectiveness of prevention with antipyretics

Victoria L Dra'gon, Patryk Jadzinski
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Abstract

Before reaching the age of 5, 2–5% of children will have had a febrile seizure. Most are categorised as simple but they can be complex and carry the risk of complications. They can be frightening for parents. UK guidelines advise against the use of antipyretic drugs to prevent febrile seizure recurrence while being mindful of parental sensitivities. This systematised literature review aimed to appraise the global body of evidence in relation to current guidelines on using conventional antipyretics for the prevention of febrile seizures and explore factors that influence their management. A research question was developed using the PICO (population/participant(s); intervention(s); comparison/control; outcome) framework and two databases were searched for primary research, and abstracts were screened for relevance. Thirty-four articles were identified, or which three were relevant to the research aim. These were critically appraised using the Mixed Methods Appraisal Tool and five themes were identified. One study found that paracetamol may prevent recurrent febrile seizures, one found a small reduction in febrile seizure recurrence when treated with an antipyretic and one found antipyretics ineffective at reducing febrile seizure recurrence. Similar contemporary studies conducted in the UK population may help to improve understanding of the factors influencing febrile seizure management and the effectiveness of antipyretics.
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热性惊厥的处理和使用退烧药预防的有效性
在 5 岁之前,2%-5% 的儿童会有过发热性癫痫发作。大多数发热性惊厥被归类为单纯性惊厥,但也可能是复杂性惊厥,并有并发症的风险。这可能会让家长感到恐惧。英国指南建议不要使用退烧药来预防发热性惊厥复发,同时也要考虑到家长的敏感性。本系统化文献综述旨在评估与使用常规退热药预防发热性癫痫发作的现行指南有关的全球证据,并探讨影响其管理的因素。我们采用 PICO(人群/参与者;干预;比较/对照;结果)框架提出了一个研究问题,并在两个数据库中搜索了主要研究,同时对摘要进行了相关性筛选。最后确定了 34 篇文章,其中 3 篇与研究目的相关。我们使用混合方法评估工具对这些文章进行了严格评估,并确定了五个主题。一项研究发现扑热息痛可预防发热性癫痫复发,一项研究发现使用退烧药治疗时发热性癫痫复发率略有降低,一项研究发现退烧药对降低发热性癫痫复发率无效。在英国人群中开展类似的当代研究可能有助于更好地了解影响发热性癫痫发作管理的因素以及退烧药的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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