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Febrile seizures in young children: Role of fluid intake and conservation

机译：幼儿高热惊厥：液体摄入和养护的作用

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Febrile seizures are a common occurrence in young children with incidence rates varying from 3–14%, depending on the geographic region. Studies have suggested that an elevated temperature is a factor in their development, though other factors may synergistically lower the seizure threshold. While it is recognized that excessive or rapid dilute fluid intake can cause seizures in young children, and in adults during strenuous physical activity, less focus has been paid to its involvement during febrile illnesses. Young children are more vulnerable to the development of febrile seizures due to their small skull size relative to brain volume. In animals, reduced serum sodium levels have been shown to lower the threshold to convulsive stimuli, while hypertonic saline has been shown to rapidly reverse these effects. Similarly vasopressin, frequently elevated during acute infections, enhances fluid retention and may also be a precipitating factor for febrile seizures. Although an elevated temperature may augment seizure risk, antipyretics have not been shown to prevent them. In fact, some may increase seizure risk through a reduction in urine output.It has long been observed that fluid retention occurs during febrile infections, followed by diuresis during convalescence. This characteristic observation led to recommendations for restricted fluid intake during acute infections dating back more than 2,000 years. Only recently has there been a return to restricted fluid intake for patients with potentially reduced free water excretion. Further studies are required to determine the role of the overall fluid balance in the etiology of childhood febrile seizures.
机译：高热惊厥在幼儿中很常见，其发病率在3-14％之间，取决于地理区域。研究表明，温度升高是其发展的一个因素，尽管其他因素可能会协同降低癫痫发作阈值。尽管人们认识到过量或快速稀释的液体摄入会导致幼儿和剧烈运动期间的成年人癫痫发作，但对于发热疾病的关注却较少。幼儿由于颅骨尺寸相对于大脑体积较小，因此更容易出现高热惊厥。在动物中，降低的血清钠水平已显示可降低惊厥刺激的阈值，而高渗盐水则可迅速逆转这些作用。同样，在急性感染期间经常升高的加压素会增加体液retention留，也可能是高热惊厥的诱发因素。尽管温度升高可能会增加癫痫发作的风险，但退烧药尚未显示出预防这种病的方法。实际上，有些药物可能会通过减少尿量而增加癫痫发作的风险。长期以来，人们一直观察到在高热感染期间会出现液体retention留，然后在恢复期会利尿。这一独特的观察结果提出了在2000年前的急性感染期间限制液体摄入的建议。直到最近才恢复了可能减少自由水排泄的患者的限制液体摄入量。需要进一步研究以确定总体体液平衡在儿童高热惊厥的病因中的作用。

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