Objective This study was aimed to determine the rate, timing, and risk factors of acute recurrence of seizures in the children admitted for nonfebrile seizure in the emergency department (ED).

Methods This multicenter prospective study was conducted in the ED of three hospitals. All consecutive visits of children aged 28 days to 15 years who attended the ED for a nonfebrile seizure for 1 year were included in the study and prospectively followed. The rate of acute seizure recurrence within 24 hours was evaluated and association with potential risk factor was tested. Timing of seizure recurrence was assessed.

Results A total of 181 ED visits were enrolled. Overall, 19.9% (36/181) of children presented acute seizure recurrence, 50% of seizure recurrence occurred during the 2 hours after ED arrival and 70% within 6 hours. Multivariable analysis showed that age of <5 years and seizure recurrence in the emergency department were associated with a significant increase in acute recurrence risk.

Conclusion Early seizure recurrence is common in children with nonfebrile seizure, with younger children at higher risk. Based on these findings, acute recurrence risk after a nonfebrile seizure should justify to observe the children admitted for a nonfebrile seizure in the ED, especially young children. A larger study should analyze other risk factors associated with increased risk of acute seizure recurrence and help ED management.

目的 本研究旨在确定急诊科 (ED) 因非热性惊厥入院的儿童癫痫发作急性复发的发生率、时间和危险因素。

方法 这项多中心前瞻性研究在三家医院的急诊部进行。因非热性惊厥到急诊室就诊 1 年的 28 天至 15 岁儿童的所有连续就诊均包括在研究中并进行前瞻性随访。评估了 24 小时内急性癫痫发作的复发率，并测试了与潜在危险因素的关联。评估癫痫发作复发的时间。

结果 共登记了 181 次急诊就诊。总体而言，19.9% (36/181) 的儿童出现急性发作复发，50% 的发作复发发生在 ED 到达后 2 小时内，70% 发生在 6 小时内。多变量分析显示，年龄 <5 岁和急诊室癫痫发作复发与急性复发风险显着增加相关。

结论 非热性惊厥患儿早期惊厥复发较为常见，年龄越小的患儿复发风险越高。基于这些发现，非热性惊厥后的急性复发风险应该证明对急诊室因非热性惊厥入院的儿童进行观察是合理的，尤其是幼儿。一项更大规模的研究应该分析与急性癫痫发作复发风险增加相关的其他风险因素，并有助于 ED 管理。