Iranian Journal of Child Neurology

Abstract

Objective

Whatever the health field, compliance with the recommended practice guidelines or parameters for diagnosis by specialists and expert health professionals benefits the patients. This study was conducted to determine the whether or not these guidelines or parameters are applied to the evaluation of children with first simple febrile convulsion (SFC) in a regional teaching hospital.

Materials & Methods

In a prospective study conducted on children with SFC, admitted in the Pediatric ward of Imam hospital, Oromieh, records of investigations ordered between Jan 2003 and Dec 2004 for children diagnosed with SFC were collected. Practice parameters of the American Academy of Pediatrics (AAP) were employed as diagnostic standards. Applied practices were compared with AAP recommended practice parameters. Investigations performed included lumbar puncture, complete blood count, CRP, ESR, blood glucose, serum calcium, electrolytes, renal function tests, urinalysis, urine culture, and blood culture, chest X-ray, EEG and CT scan.

Results

Two hundred and fifty-one consecutive cases, aged 6-60 months, were evaluated. Complete blood count, blood glucose, serum calcium, serum electrolytes, renal function tests, urinalysis, urine culture, and blood culture were tested in all cases (100%). Lumbar puncture, chest X-ray, EEG and CT brain scan had been performed in 10%, 24%, 1.4% and 0.65% of cases, respectively. The mean number of routine investigations was twelve.

Conclusion

Compared to recommended practice guidelines the results of this study highlighted that children with first SFC had more often than necessary investigation. These, not only resulted in significant expense, they proved to be of little diagnostic value. Compliance with a centrally organized national program would significantly help to improve SFC evaluation.

Keywords: Febrile convulsion, Simple fébrile seizure, Lumbar puncture, Convulsion, Fever