熱性けいれん(熱性発作)診療ガイドライン 2023

出版社: 診断と治療社
著者:
発行日: 2023-01-01
分野: 臨床医学:内科  >  小児科学一般
ISBN: 9784787825643
電子書籍版: 2023-01-01 (電子版)
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日常診療でよく遭遇する熱性けいれん(熱性発作)の初期対応,検査,薬の使い方,注意すべき薬剤,予防接種についてCQ形式でわかりやすく解説.2023年版では前版に寄せられたご意見を踏まえ,CQの内容の更新,遺伝に関する項目,保護者向けの発熱時ジアゼパム坐剤予防投与のパンフレット例や海外の熱性けいれんのガイドラインの紹介を加えより充実した1冊に.

目次

  • Introduction
    熱性けいれん(熱性発作)診療ガイドライン2023 作成組織
    CQ・推奨・要約一覧

    第1部 総論
    総論1 熱性けいれん(熱性発作)の定義
    総論2 単純型熱性けいれんと複雑型熱性けいれん
    総論3 熱性けいれん重積状態の定義
    総論4 熱性けいれんの遺伝,遺伝子
    総論5 熱性けいれんの再発頻度と再発予測因子
    総論6 熱性けいれん患児のその後のてんかん発症頻度とてんかん発症関連因子
    総論7 年長児の有熱時発作

    第2部 各論
    1.初期対応
    CQ1-1 有熱時発作を認め救急受診した場合に髄液検査は必要か
    CQ1-2 有熱時発作を認め救急受診した場合に血液検査は必要か
    CQ1-3 有熱時発作を認め救急受診した場合に頭部画像検査は必要か
    CQ1-4 有熱時発作を起こした小児において入院(入院可能な病院への搬送)を
        考慮する目安は何か
    CQ1-5 来院時に熱性けいれんが止まっている場合に外来でジアゼパム坐剤を
        使用したほうがよいか

    ◉有熱時発作の初期対応フローチャート

    2.熱性けいれん重積状態
    CQ2-1 熱性けいれん重積状態の初期治療薬は何か
    CQ2-2 遷延性の有熱時発作を起こした小児において有用な検査は何か

    3.脳波検査
    CQ3-1 熱性けいれんの既往がある小児において脳波検査は
        てんかん発症や熱性けいれん再発の予測に有用か
    CQ3-2 熱性けいれんを起こした小児における脳波異常にはどのようなものがあるか
    CQ3-3 熱性けいれんを起こした小児において,脳波異常がみられやすい患児の
        臨床的特徴はあるか

    4.治療(1)発熱時のジアゼパム坐剤
    CQ4-1 熱性けいれんの既往がある小児において発熱時のジアゼパム投与は必要か.
        適応基準は何か
    CQ4-2 発熱時のジアゼパムの投与量,投与方法,投与対象期間および
        使用上の注意事項は何か

    ◉参考資料1 ジアゼパム坐剤の使用法の養育者への説明について

    5.治療(2)抗てんかん薬内服
    CQ5-1 熱性けいれんの既往がある小児において抗てんかん薬の継続的内服を行うべきか

    6.治療(3)解熱薬
    CQ6-1 熱性けいれんの再発予防のために解熱薬を使用すべきか

    7.注意すべき薬剤
    CQ7-1 熱性けいれんの既往がある小児で注意すべき薬剤は何か
       1.発熱性疾患に罹患中に鎮静性抗ヒスタミン薬を使用してよいか
       2.テオフィリン等のキサンチン製剤を使用してよいか

    ◉参考資料2 抗ヒスタミン薬と発作に関して

    8.予防接種
    CQ8-1 熱性けいれんの既往がある小児は予防接種をうけてよいか
    CQ8-2 発熱が誘発されやすいワクチンの種別は何か.またその発熱時期はいつ頃が多いか
    CQ8-3 熱性けいれんの既往がある小児に予防接種を行う場合,
        最終発作からの経過観察期間をどれくらいあければよいか

    ◉参考資料3 海外のガイドライン

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

第1部 総論

P.3 掲載の参考文献
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P.5 掲載の参考文献
1) Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizure. N Engl J Med 1976;295:1029-1033.
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3) Subcommittee on Febrile Seizures;American Academy of Pediatrics. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics 2011;127:389-394.
4) 福山幸夫, 関亨, 大塚親哉, 三浦寿男, 原美智子. 熱性けいれんの指導ガイドライン. 小児臨 1996;49:207-215.
5) Berg AT, Shinnar S. Complex febrile seizures. Epilepsia 1996;37:126-133.
6) Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316:493-498.
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P.9 掲載の参考文献
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P.13 掲載の参考文献
1) Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia 1994;35(Suppl 2):S1-6.
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P.17 掲載の参考文献
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4) Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976;295:1029-1033.
5) Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures. Pediatrics 1978;61:720-727.
6) Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316:493-498.
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16) Canpolat M, Per H, Gumus H, Elmali F, Kumandas S. Investigating the prevalence of febrile convulsion in Kayseri, Turkey:an assessment of the risk factors for recurrence of febrile convulsion and for development of epilepsy. Seizure 2018;55:36-47.
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20) Patel N, Ram D, Swiderska N, Mewasingh LD, Newton RW, Offringa M. Febrile seizures. BMJ 2015;351:h4240.
21) Leung AK, Hon KL, Leung TN. Febrile seizures:an overview. Drugs Context 2018;7:212536.
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P.19 掲載の参考文献
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8) Zhang Y-H, Burgess R, Malone JP, et al. Genetic epilepsy with febrile seizures plus:Refining he spectrum. Neurology 2017;89:1210-1219.

第2部 各論

P.25 掲載の参考文献
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a) ジアゼパム坐剤(ダイアップ(R))薬品説明添付文書
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