prognosis is usually good even though a low proportion ( 2 - 4% ) go on to develop epilepsy.12 however , mortality can arise from poor or unorthodox management.7 kaduna is in northwestern nigeria a region with high under - five mortality rate in the country and , where care givers have demonstrated inappropriate management of febrile illnesses in children.1315 the aim of the study was to review the current status of febrile seizures in kaduna metropolis .
we reviewed hospital records of 635 children to determine the rate and descriptions of febrile seizures among admissions in the department of paediatrics , 44 nigeria army reference hospital ( narh ) , a tertiary health facility in kaduna , between june 2008 and june 2010 .
all who had seizures or seizure related disorders were reviewed for history of fever , type of seizure , level of consciousness using the glasgow coma scale ( gcs),16 outcome of cerebrospinal fluid ( csf ) analyses , urea and electrolytes , random blood sugar , blood film for malaria parasitemia , full blood count , electroencephalogram ( eeg ) and cultures of throat swab , urine , stool and blood , where indicated .
other parameters reviewed were age , sex , social class , actions taken by parents and outcome of hospitalization .
social class classification was that of the parents and based on oyedeji 's classification17 and utilized by akpan et al,18 ; grade i- professionals , senior public servants , large scale businessmen ; grade ii - intermediate civil servants , senior school teachers ; grade iii - junior school teachers , drivers and artisans with secondary education ; grade iv - petty traders , laborers , messengers and grade v - unemployed , students , and subsistence farmers . those reviewed fulfilled the following criteria for febrile seizures12 : 
 had a history of fever associated with the onset of seizurehad seizures described as generalized tonic - clonic convulsion , an episode in 24 h lasting less than 15 min ( simple febrile seizure ) or greater than 15 min or multiple convulsions in 24 h ( complex febrile seizure)non - central nervous system infection
as indicated by absence of bacterial isolates in the csf or the combination of pleocytosis , reduced csf glucose and elevated csf protein level19full regaining of consciousness after seizure as indicated by a normal gcs . 
  had a history of fever associated with the onset of seizure had seizures described as generalized tonic - clonic convulsion , an episode in 24 h lasting less than 15 min ( simple febrile seizure ) or greater than 15 min or multiple convulsions in 24 h ( complex febrile seizure ) non - central nervous system infection as indicated by absence of bacterial isolates in the csf or the combination of pleocytosis , reduced csf glucose and elevated csf protein level19 full regaining of consciousness after seizure as indicated by a normal gcs .
discrete variables were further assessed for significance using chi - square and fisher 's exact where applicable .
discrete variables were further assessed for significance using chi - square and fisher 's exact where applicable .
out of 635 cases , 79 ( 12.4% ) children had seizures or seizure related disorders [ table 1 ] .
of these 17 , 21.5% of the seizure related disorders and 2.7% of the total cases , fulfilled the criteria for febrile seizures .
meningitis seen in 33 children was the commonest ( 41.8% ) among the seizure related disorders .
disease conditions among 79 patients with seizure related disorders there were 11 males and 6 females ( m : f , 1.8:1).there was a male preponderance .
the mean age was 2.2 years1.1 with a range of 9 months to 5 years and a peak age of 3 years .
twelve ( 70.6% ) were in the upper social classes ( i - iii ) while the others were in the lower classes ( iv and v ) .
age and sex distribution of 17 patients with febrile seizures all the 17 eligible children presented with fever and convulsions [ table 3 ] .
other symptoms were cough , catarrh , abdominal pain , headache , diarrhea and sore throat .
the main physical and laboratory findings were under weight , inflamed pharynx , anaemia , malaria parasitemia and neutrophilia .
comparatively , only the presence of convulsions and coma were significantly ( p < 0.05 ) commoner in the 79 children presenting with seizures or seizure related disorders as against the others without seizures .
clinical features of 17 patients with febrile seizures eleven ( 64.7% ) received an antipyretic ( acetaminophen ) or an anti - inflammatory ( ibuprofen ) drug .
six ( 35.3% ) were given antimalarials syrups ( chloroquine , sulphadoxine / pyrimethamine , artesunate or quinine ) while 2 were given an antibiotic ( metronidazole ) for diarrhea .
seven ( 41.2% ) had traditional herbal mixture given orally or rubbed on the skin during or after a seizure .
five ( 29.4% ) consulted patent medicine sellers ( pms ) and received an antimalarial ( chloroquine , artesunate , or quinine syrup ) and an antibiotic ( chloramphenicol , co - trimoxazole or ampicillin / cloxacillin ) .
thrusting of an object ( mainly the finger or spoon ) in the mouth during the seizure was the major physical intervention undertaken .
actions taken by caregivers of 17 of patients with febrile seizures drug administration was characterized by inadequate and irregular dosing .
fourteen ( 82.4% ) had simple febrile seizures while 3 ( 17.6% ) had the complex variety .
there was a positive family history in 5 ( 29.4% ) cases : 2 among those with simple seizures and all the three with complex seizures .
it was the first episode in 11 ( 64.7% ) cases and all simple seizures . in 6 ( 35.3% ) of the cases experiencing a second seizure ,
the causes were , only malaria in 7 ( 41.2% ) cases , acute respiratory infections alone in 5 ( 29.4% ) and a combination of malaria and ari in the remaining 5 ( 29.4% ) . where indicated an antimalarial ( artesunate / lumefantrine combination ) and/or antibiotic ( amoxicillin for those without prior antibiotic administration and cefuroxime for those with previous antibiotic administration )
the prevalence of febrile seizures among hospitalized patients in this study ( 2.7% ) was low compared to that seen at other centers in nigeria.72021 this might be attributable to home treatment , presentation at lower levels of health care delivery or an actual reduction of its incidence in the community .
has also been reported in other studies.21 tailor et al , opined that the comparatively earlier maturation of the female brain could provide protection against potential triggers such as fever.22 others have inferred that such observation could be as a result of cultural attitude that encourages earlier presentation of males.2123 the higher number of patients in the upper social classes could be as a result of this group 's capacity to access and afford health care.24 the observation of a positive family history in some of the patients support a genetic basis for its occurrence and this has been previously highlighted.123 furthermore , the occurrence of most seizures after the first day of onset of symptoms underscores the need to urgently identify and adequately manage underlying conditions .
also , the incidence of all the complex seizures in the subsequent episodes of febrile seizures suggests a higher risk of its occurrence among those with recurrent febrile seizures .
it calls for closer monitoring of fever in those who have had an episode of simple febrile seizure .
inappropriate home management of fever , which has also been observed by audu and ogala in zaria,14 and ndifon et al , in calabar,25 was also noted in the study .
the implication is the subsequent development of severe or complicated forms of disease among children as observed by eseigbe et al.15 however , it unveils the beneficial potential of caregivers , if properly trained on home management of common childhood illnesses , in child health care delivery in the country .
patent medicine sellers are part of the informal health sector in the country and licensed to sell mainly over the counter drugs .
however , they have been found to prescribe and sell proprietary drugs , inappropriately and incompetently , beyond their statutory limits . due to their accessibility and affordability ,
the pms were patronized for the management of febrile seizures in this study and they rendered extracurricular services inappropriately .
it can be concluded , as did akuse et al , that with proper training pms have the potential to improve control of common diseases in the community .
the use of traditional medicine observed in the study is in conformity with the fact that its use is a viable part of the complex health care system in nigeria.2627 furthermore , it underscores the need to address its role in health care delivery in the country .
the use of traditional medication , and its attendant challenges , in the treatment of febrile convulsions and other seizure related disorders have been documented in other parts of the country.212829 ojukwu et al , reported that mortality with febrile seizures was associated with traditional medicine ingestion.7 considering the degree of utilization , traditional medicine if properly harnessed could play a more significant role in health care in the country .
an example is seen with valuable use of artesunate , obtained from a chinese herbal extract , in the treatment of malaria.30 some of the pre - hospital interventional practices carried out by the care givers in this study and that observed in other similar studies,212829 such as thrusting of objects in the mouth of a convulsing child , application of onion squash to the eyes , applying scarification marks to the body and burning of the feet , are harmful .
its occurrence emphasizes the need to improve public awareness about seizure related disorders and their pre - hospital management .
malaria and ari , major causes of childhood illness in the country,3132 were the identifiable causes of febrile seizures in this study .
this was similar to findings of osaghae and mukwuzi - odum in benin city21 where both conditions were associated with 80% of the children with febrile convulsions .
it highlights the need to vigorously pursue already existing programs such as millennium development goal 633 targeted at combating endemic diseases and , implementing new policies geared towards prevention and control of these conditions .
the study revealed a low prevalence of febrile seizures among hospitalized patients with majority presenting with the first episode of the simple variety and poor pre - hospitalization management .
it highlighted the need to improve community awareness , establish appropriate caregiver health seeking behavior and promote malaria and ari prevention initiatives .
 background : febrile seizure is the most common seizure of childhood and has a good prognosis . 
 however its presentation is fraught with poor management , with grave consequences , in our environment . 
 thus a review of its current status is important.objective:to review the status of febrile seizures in kaduna metropolis.materials and methods : a review of cases seen in the department of paediatrics , 44 nigeria army reference hospital , kaduna between june 2008 and june 2010.results:out of the 635 cases admitted in the department 17 ( 2.7% ) fulfilled the criteria for febrile seizures . 
 there were 11 males and 6 females ( m : f , 1.8:1 ) . 
 age range was from 9 months to 5 years with a mean of 2.2 years  1.1 and peak age of 3 years . 
 twelve ( 70.6% ) were in the upper social classes ( i - iii ) . 
 fever , convulsion , catarrh and cough were major presenting symptoms . 
 incidence of convulsion was least on the 1st day of complaint . 
 fourteen ( 82.4% ) of the cases were simple febrile seizures while 3 were complex . 
 there was a positive family history in 5 ( 29.4% ) of the cases . 
 eleven ( 64.7% ) had orthodox medication at home , before presentation , 5 ( 29.4% ) consulted patient medicine sellers and 7 ( 41.7% ) received traditional medication as part of home management . 
 malaria and acute respiratory infections were the identifiable causes . 
 standard anti - malaria and anti - biotic therapy were instituted , where indicated . 
 all recovered and were discharged.conclusion:there was a low prevalence of febrile seizures among the hospitalized children and a poor pre - hospitalization management of cases . 
 it highlighted the need for improved community awareness on the prevention and management of febrile seizures . 
INTRODUCTION
MATERIALS AND METHODS
Data analysis
RESULTS
DISCUSSION
CONCLUSION