Comparing Febrile Convulsion Therapy Guidelines with Current Practices in First Simple Febrile Convulsion

Febrile convulsion is a disease with good prognosis but its mismanagement leads patients to serious complications. T his study was conducted to compare practice guidelines with current practices in the management of children with first febrile convulsion. This descriptive-analytical study was conducted on patients hospitalized with the diagnosis of first febrile convulsion in Imam-Khomeni hospital of Urmia in 2004. The data were collected from their hospital records. Practice guidelines of the American Academy of Pediatrics (AAP) were employed as reference. Current practices were compared with AAP recommended practice parameter about simple febrile seizure. Investigations performed included lumbar puncture, complete blood count, CRP, ESR, blood glucose, serum calcium, serum electrolytes, renal function tests, urinalysis, urine, and blood culture, chest X-ray, EEG and CT scan. T wo hundred fifty one cases aged 6-60 months were studied. Complete blood count, ESR, CPR, blood glucose, serum calcium, serum electrolytes, renal function tests, urinalysis, urine culture, and blood culture in all cases (100%), lumbar puncture in 10%, chest X-ray in 24%, EEG in 1.4% and CT scan in 0.65% of cases were the measurements conducted. The present study showed that the use of unnecessary investigations was common. Investigations, though costly, proved to be of little diagnostic value. This problem can be alleviated through a well-organized national program or observing AAP practical guidelines.