ObjectiveAccording to the diagnosis and treatment analysis of 5 children with Febrile infection-related epilepsy syndrome (FIRES) and literature review, to explore the therapeutic effect of Ketogenic diet (KD).MethodsA retrospective analysis of the clinical status of 5 children with KD treatment of FIRES admitted to the Department of Pediatric Neurology, West China Second Hospital of Sichuan University from August 2016 to September 2019, combined with literature data, summarized their disease characteristics, prognosis and KD treatment effects.ResultsThe 5 cases of FIRES children were (5.8±2.0) years old and had a male to female ratio of 2∶3. They were all induced by fever followed by a status epilepticus that was difficult to control with drugs. The interval between fever and first seizure was 4 to 7 days, and the prodromal symptoms were higher respiratory tract infections, dizziness, vomiting, fatigue, listlessness, loss of appetite, etc., convulsions manifested as focal or focal secondary systemic or general seizures, EEG showed slowing background rhythm, changes in multifocal epileptic discharge, early course of disease The cranial imaging examination was basically normal. As the course of the disease progressed, changes in brain atrophy gradually appeared, and abnormal signal shadows were seen in the forehead, parietal, occipital lobe, and periventricular. A variety of anti-epileptic drugs, hormones, gamma globulin, plasma exchange and other treatments have poor therapeutic effects and severe cognitive impairment. The KD treatment started to take effect within 2 weeks, and the convulsions were reduced. One case was completely controlled, and the cognitive function basically returned to normal with only mild learning disabilities; the convulsions were reduced by more than 50% in 2 cases, leaving mild to moderate cognitive impairment, The other 2 cases had poor long-term treatment effects, left intractable seizures and severe mental retardation.ConclusionFIRES is a serious epileptic encephalopathy, most of which leave severe cognitive impairment and refractory seizures. Drug therapy and prognosis are poor. KD treatment is beneficial to control seizures in children with FIRES in the acute stage.
Objective To explore the effect of chloral hydrate on sleep Electroencephalogram (EEG) in children. Methods A total of 250 children under the age of 5 underwent EEG examination in West China Second University Hospital from Nov.8, 2019 to Sep.1,2021 were enrolled and divided into medication group or non-medication group according to whether they took chloral hydrate before the examination. Among them, 167 patients, the average age of whom was (30.78±17.43) months, were in the medication group, with a male to female ratio of 113:54. 83 cases were in the unmedicated group, the ratio of male to female was 60:23, and the average age was (33.12±17.10) months. There were no statistical difference in age and gender between the two groups. Quantitative EEG method was used to compare and analyze the percentages of the power of various EEG waveforms in the two groups. Results The proportion of EEG beta waves in the medication group was (2.76±4.03)%, and the proportion of EEG beta waves in the non-medication group was (1.59±1.21)%. There was a significant difference between the two groups. The proportion of sleep EEG beta waves in the medication group is higher. Conclusions Chloral hydrate may cause the increase of β fast waves in sleep EEG, which may affect the interpretation of EEG and the diagnosis of diseases.