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Fieberkrämpfe und Epilepsie

Febrile seizures and epilepsy

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Zusammenfassung

Etwa 3% aller Kinder mit Fieberkrämpfen erkranken später an einer Epilepsie. Dieses Risiko ist bei einfachen Fieberkrämpfen niedriger und steigt bei komplexen in Abhängigkeit von der Anzahl der Komplexitätsfaktoren von 4–49% an. Mehrheitlich treten epileptische Anfälle nach den Fieberkrämpfen auf. Gelegentlich können Letzteren Neugeborenenkrämpfe (v. a. benigne familiäre) und einige Epilepsieformen der frühen Kindheit vorausgehen. Eine besondere Gruppe sind die Ionenkanalstörungen (Na+-Kanal und GABAA-Rezeptoren). Sie führen zum Krankheitsbild „generalisierte Epilepsie mit Fieberkrämpfen plus“ (GEFS+). Diese Störungen können unterschiedlich schwer verlaufen, d. h. von der therapeutisch problemlosen GEFS+ bis zur therapieresistenten schweren myoklonischen Epilepsie, welche mit einem zunehmenden psychomotorischen Entwicklungsrückstand verbunden ist.

Abstract

An epileptic seizure is seen in about 3% of all pediatric febrile seizure patients. This risk is lower in children with simple febrile seizures but increases for complex febrile seizures, depending on the number of complexity factors, from 4% to 49%. Febrile seizures precede various forms of epilepsy in the majority of cases. Newborns with benign familial neonatal seizures have a higher prevalence of febrile seizures. Generalized epilepsies with febrile seizures plus (GEFS+) are important familial epileptic syndromes caused by channelopathies (voltage gated sodium channels and GABAA receptors). GEFS+ is characterised by heterogeneous clinical phenotypes ranging from mild febrile seizures to severe myoclonic epilepsies of infancy (SMEI). There is also a slowing of the psychomotor development in SMEI patients.

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  1. Universitätskinderklinik beider Basel, Postfach, 4005 , Basel , Schweiz

    J. Lütschg

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  1. J. Lütschg
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Lütschg, J. Fieberkrämpfe und Epilepsie. Monatsschr Kinderheilkd 155, 425–430 (2007). https://doi.org/10.1007/s00112-007-1510-0

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  • DOI: https://doi.org/10.1007/s00112-007-1510-0

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