Retrospective analysis of patients with clusters of seizures accompanied with fever

<p>  Objective: This study aimed to examine the management of patients with clusters of seizures accompanied by fever (SaF) via investigation of their clinical characteristics and laboratory data. Methods: Patients with clusters of SaF admitted to Toyooka Public Hospital between 2011 and 2021 were retrospectively included and divided into two groups : Group A (seizures repeated only twice) and Group B (seizures repeated thrice or more). Those who had epilepsy, underlying disorders associated with seizures, and convulsive status epilepticus were excluded. Results: Overall, 223 patients were included, with 169 in Group A and 54 in Group B. All included patients exhibited no abnormal neurological findings at the time of discharge. The length of hospital stay was longer in Group B than in Group A. Group B also had higher AST/ALT and lower blood glucose levels than Group A (P＜0.05). Seizure suppression rate after the administration of diazepam (DZP) suppository was 80% in patients who used DZP after second seizure and 90.9% in those who used it after three or more seizure clusters. The seizure suppression rate after the third seizure was not significantly different between those with and without DZP suppository use. Conclusions: Approximately one-fourth of children with SaF had three or more clusters of seizures. Although the serum AST/ALT level may be a useful marker for prediction of seizure cluster, further investigations are required owing to its low sensitivity and specificity. Moreover, the effect of DZP suppository for the purpose of suppressing seizure clusters remains unknown. Indications of hospitalization and intervention for patients with SaF should be considered depending on the access to the hospital, medical resources in each region, and burden on caregivers of patients.</p>