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Klinik, Behandlung und Verlauf von Fieberkrämpfen

Febrile seizures: clinical manifestations, anticonvulsive therapy, outcome

  • Leitthema
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Zusammenfassung

Fieberkrämpfe sind epileptische Gelegenheitsanfälle von Säuglingen und Kleinkindern, verursacht durch fieberhafte Infektionen nicht des ZNS. Sie sind meist tonisch-klonisch generalisiert, zu 90% zeitlich selbstlimitiert und bedürfen somit selten einer antikonvulsiven akuten Therapie. Sie verursachen keine Schädigungen des ZNS und gehen nur selten in Epilepsien über. Die einfache Applikationsmöglichkeit rektalen Diazepams entlastet aber maßgeblich die Eltern in ihren Todesängsten um ihr betroffenes Kind. Eine antikonvulsive Dauertherapie ist nur bei im Verlauf rezidivierenden komplizierten Fieberkrämpfen zu erwägen. Eine intermittierende Benzodiazepingabe bei Fieber ist möglich. Antipyretika können hingegen keine Fieberkrämpfe verhindern.

Abstract

Febrile seizures occur occasionally in infants and small children. They are caused by febrile infections not involving the CNS. Clinical manifestations are usually generalized and self-limited. Acute intervention is rarely needed. Outcome is excellent, neurological sequelae are not known; only a few cases develop epilepsies. Intervention with rectal diazepam is easy. This helps frightened parents to overcome their fear that the child could die. Continuous anticonvulsive therapy is effective but only indicated in selected cases of recurrent complex febrile seizures. Intermittent benzodiazepine prophylaxis is possible. Antipyretic therapies are not useful for prevention.

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Authors and Affiliations

  1. Zentrum für Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln, Deutschland

    F. Aksu

  2. Abteilung/Schwerpunkt Neuropädiatrie, Katholisches Kinderkrankenhaus Wilhelmstift, Liliencronstraße 130, 22149, Hamburg, Deutschland

    B. Püst

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Aksu, F., Püst, B. Klinik, Behandlung und Verlauf von Fieberkrämpfen. Monatsschr Kinderheilkd 155, 419–424 (2007). https://doi.org/10.1007/s00112-007-1500-2

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