THE LABORATORY AND NEUROIMAGING INVESTIGATIONS IN THE DIAGNOSTIC APPROACH OF FEBRILE SEIZURES
Abstract:
The opportunity of the laboratory and neuroimaging investigations in the study of febrile
seizures (FS) is determined by clinical parameters such as the type and number of the FS, age,
neurological status, presence of anamnestic or clinical risk factors, type of the underlying infectious
disease. Biomarkers with potential role in the differential diagnosis of FS (prolactin, creatin kinases) or
assessing the risk of recurrence (iron deficiency) have been identified. The lumbar puncture (LP) is not
recommended in the routine evaluation of the SFS (simple febrile seizures) with normal neurological
exam and complete immunization schedule, or in the case of CFC (complex febrile seizures) with absent
predictors for meningitis. The LP should be considered in patients aged 6-12 months with uncertain
immunological status, in the absence of vaccination for Streptococcus pneumoniae or Haemophilus
influenzae and in the presence of the clinical factors suggestive of meningitis. The neuroimaging
assessment is not indicated in the emergency unit for the first SFS or for the CFS associated with normal
neurological exam and good general condition, but is recommended in the context of an evocative
clinical picture for a neurological disorder or recurrent CFS.
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