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Review paper

Retinal changes in febrile seizures in children: a retrospective analysis in Tuzla Canton, Bosnia and Herzegovina

By
Meliha Halilbašić Orcid logo ,
Meliha Halilbašić
Contact Meliha Halilbašić

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Amra Nadarević Vodenčarević ,
Amra Nadarević Vodenčarević

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Anis Međedović ,
Anis Međedović

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Amir Halilbašić ,
Amir Halilbašić

Clinic for Children’s Diseases, University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina

Almira Ćosićkić ,
Almira Ćosićkić

Clinic for Children’s Diseases, University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina

Ajla Pidro
Ajla Pidro

Eye Clinic Dr. Ismail , Sarajevo , Bosnia and Herzegovina

Abstract

Aim
To evaluate the possibility of retinal haemorrhages or any other retinal pathology caused by febrile seizures alone in children aged between 2 months and 15 years.
Methods
Children aged between 2 months and 15 years admitted to the hospital following seizures were examined within 48 hours
of admission. The seizures were classified by a paediatric neurologist and a detailed ocular examination, including indirect ophthalmoscopy, was performed by an ophthalmologist.
Results
In the period between May 2019 and May 2020 a total number of 106 children were examined. There were 66 (62.3%)
male and 40 (37.7%) female children. The youngest patient was 2 months old and the oldest patient was 15 years old. None of the children was found to have retinal haemorrhages or any other retinal pathology.
Conclusion
Retinal haemorrhages or any other acute retinal findings in children with febrile seizures are very rare, but we cannot
rule out its occurrence. The finding of retinal haemorrhages in a child admitted with a history of seizure should trigger a detailed search for other causes of those haemorrhages, especially shaken baby syndrome. Due to the lack of any manifestations on the retina after febrile seizure, maybe it is time that the current protocol and guidelines, considering obligatory fundus examination, should be re-examined

References

1.
Mei-Zahav M, Uziel Y, Raz J, Ginot N, Wolach B, Fainmesser P. Convulsions and retinal hemorrhage: should we look further? Arch Dis Child. 2002;334–5.
2.
Acta Med Croatica. 2008;511–5.
3.
Mustafić N, Tahirović H, Trnovcević J, Kapidzić A. Klinicke karakteristike prvih febrilnih konvulzija (Clinical characteristics at onset of first febrile convulsions).
4.
Guo H, Lan Y, Wang M, Xiao J, Hu Y, Xia Z. Manifestations of ocular fundus in children with febrile seizures. J Pediatr Ophthalmol Strabismus. 2011;182–6.
5.
Tyagi A, Scotcher S, Kozeis N, Willshaw H. Can convulsions alone cause retinal hemorrhages in infants? Br J Ophthalmol. 1998;659–60.
6.
Sandramouli S, Robinson R, Tsaloumas M. Retinal hemorrhages and convulsions. Archives of Disease in Childhood. 1997;449–51.
7.
Millichap J, Millichap J. Diurnal and seasonal occurrence of febrile seizures. Pediatr Neurol Briefs. 2015;29.
8.
Mikkonen K, Uhari M, Pokka T, Rantala H. Diurnal and seasonal occurrence of febrile seizures. Pediatr Neurol. 2015;424–7.
9.
Dreier J, Li J, Sun Y, Christensen J. Evaluation of long-term risk of epilepsy, psychiatric disorders, and mortality among children with recurrent febrile seizures: a national cohort study in Denmark. JAMA Pediatr. 2019;1164–70.
10.
Choi Y, Jung J, Kim J, Kwon H, Park J, Kwak Y, et al. Febrile seizures: Are they truly benign? Longitudinal analysis of risk factors and future risk of afebrile epileptic seizure based on the national sample cohort in South Korea. Seizure. 2002;77–83.
11.
Hanley J, Hand L, A. If nothing goes wrong, is everything all right? Interpreting zero numerators. JAMA. 1983;1743–5.
12.
Eypasch E, Lefering R, Kum C, Troidl H. Probability of adverse events that have not yet occurred: a statistical reminder. BMJ. 1995;619–20.
13.
Census of population, households and dwellings in Bosnia and Herzegovina. 2013;
14.
Alexander D. The Febrile Seizure. 3AD;
15.
Febrile Convulsions Clinical Guideline V4. 3AD;
16.
Leung A, Hon K, Leung T. Febrile seizures: an overview. Drugs Context. 2018;212536.
17.
Kaur B, Taylor D. Fundus hemorrhages in infancy. Surv Ophthalmol. 1992;1–17.
18.
Gayle M, Kissoon N, Hered R, Harwood-Nuss. Retinal hemorrhage in the young child: a review of etiology, predisposed conditions, and clinical implications. J Emerg Med. 1995;233–9.
19.
Shi A, Kulkarni A, Feldman K. Retinal findings in young children with increased intracranial pressure from nontraumatic causes. Pediatrics. 2019;
20.
Shiau T, Levin A. Retinal hemorrhages in children: the role of intracranial pressure. Arch Pediatr Adolesc Med. 2012;623–8.
21.
Binenbaum G, Rogers D, Forbes B. Patterns of retinal hemorrhage associated with increased intracranial pressure in children. Pediatrics. 2013;430-e434.
22.
Kliegman R, Geme J. Nelson Textbook of Pediatrics. 2020;
23.
Laino D, Mencaroni E, Esposito S. Management of pediatric febrile seizures. Int J Environ Res Public Health. 2018;2232.
24.
Shankar P, Mahamud S. Clinical, epidemiological and laboratory characteristics of children with febrile seizures. Int J Contemp Pediatr. 2020;1598–605.
25.
Han D, Kim S, Lee N, Yi D, Yun S, Lim I, et al. Seasonal distribution of febrile seizure and the relationship with respiratory and enteric viruses in Korean children based on nationwide registry data. Seizure. 2019;9–13.
26.
Sharafi R, Hassanzadeh R, Aminzadeh V. Circadian rhythm and the seasonal variation in childhood febrile seizure. Iran J Child Neurol. 2017;27–30.
27.
Smith D, Sadler K, Benedum M. Febrile Seizures: Risks, evaluation, and prognosis. Am Fam Physician. 2019;445–50.
28.
Paul S, Seymour M, Flower D, Rogers E. Febrile convulsions in children. Nurs Child Young People. 2015;14–5.
29.
Patel N, Ram D, Swiderska N, Mewasingh L, Newton R, Offringa M. Febrile seizures. BMJ. 2015;4240.

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