Avaliação Diagnóstica de Convulsões Febris: Desafios e Novas Perspectivas

Abstract

Introduction: Febrile seizures (FS) are common events in childhood, characterized by convulsive episodes during fevers in children aged 6 to 60 months. The lack of understanding of the pathogenesis, the variety of clinical presentations, and the implications for neurological development make understanding and accurate diagnosis essential. Methodology: Integrative review in the PubMed database (February 2024) with 139 selected articles. Criteria included publications between 2018 and 2023, free access, and direct approach to the themes. Six remaining articles were carefully read, presenting descriptive results in categories such as definition, epidemiology, the importance of accurate diagnosis, differential diagnoses, and complementary exams. Results: FS occur in children with fever, without electrolyte imbalance, metabolic disorder, intoxication, trauma, history of previous afebrile seizure, or central nervous system infection. The pathogenesis is unknown, associated with viral infections, genetic susceptibility, and vaccines. Classified as simple and complex, with CFCs associated with a higher risk of epilepsy. Epidemiologically, they affect 2-5% of children between 6 months and 5 years, with a peak at 18 months and a higher incidence in boys. Zinc deficiency increases the risk, suggesting supplementation as a preventive strategy. Accurate diagnosis is crucial for proper treatment and avoidance of unnecessary tests. Recurrence is common in the first two years, with risk factors such as younger age at first seizure, short duration of fever, and family history. EEG is vital to differentiate CFCs from other neurological conditions. Conclusion: The review emphasizes the need to understand FS, addressing the definition of febrile seizure, epidemiology, the importance of accurate diagnosis, differential diagnoses, and complementary exams. It highlights the importance of clear definition, varied epidemiology, and the influence of genetic and perinatal factors. Zinc deficiency opens up perspectives for preventive strategies. Accurate diagnosis is crucial for proper treatment and avoidance of unnecessary tests, with EEG playing an essential role. The conclusion highlights the importance of regular monitoring and continuous research to improve preventive and therapeutic strategies, contributing to pediatric health.