Fieberassoziierte Anfälle

Einleitung

Fieberassoziierte Anfälle sind ein Phänomen, mit dem sowohl ambulant als auch klinisch tätige Kinderärzte oft konfrontiert werden. Während die betroffenen Familien oft in der Akutsituation extrem verunsichert sind, stellen die Anfälle zumeist harmlose Epiphänomene fieberhafter Infekte dar (Abb. [1]). Fieberkrämpfe sind mit einer Inzidenz von 2 – 5 % zwischen dem 6. Lebensmonat und dem vollendeten 6. Lebensjahr die häufigste Manifestationsform zerebraler Anfälle beim Kind. Es handelt sich dabei um altersabhängige Anfallsereignisse bei neurologisch gesunden Kindern, welche durch erhöhte Körpertemperaturen ausgelöst werden.

Der versorgende Pädiater sollte daher:

einen febrilen Status Epilepticus (SE) nicht übersehen, differenzialdiagnostisch fieberassoziierte symptomatische Anfälle ausschließen und die Aufklärung und Beruhigung der Eltern nicht aus den Augen verlieren.

Merke: Grundsätzlich gilt es, Fieberkrämpfe von fieberassoziierten, symptomatischen Krampfanfällen zu unterscheiden.

Dass es sich bei einem fieberassozierten Anfall um die Erstmanifestation eines Epilepsie-Syndroms handelt, ist eher unwahrscheinlich.

Abb. 1 Fieberkrämpfe stellen die harmloseste und gleichzeitig häufigste Variante fieberassoziierter Anfälle dar. Quelle: PhotoDisc, Symbolbild.

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