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Retrospective study of late febrile seizures
D W Webb1, R R Jones, A Y Manzur
1Division of Paediatric Neurology, University of British Columbia and British Columbia Children's Hospital, Vancouver, Canada.
Insights
Late-onset febrile seizures in children, occurring after age five, are uncommon and typically resolve by age ten. The risk of developing afebrile seizures is low in this population.
Area of Science:
- Pediatric Neurology
- Clinical Neuroscience
- Epilepsy Research
Background:
- Febrile seizures are common in childhood, typically starting before age five.
- Late-onset febrile seizures (after age five) are less common and their long-term implications are not well-defined.
Purpose of the Study:
- To investigate the clinical features, EEG findings, and outcomes of children experiencing febrile seizures after five years of age.
- To determine the recurrence rate and cessation age of late-onset febrile seizures.
- To assess the risk of developing afebrile seizures and other long-term difficulties.
Main Methods:
- Retrospective study of 50 children with febrile seizures onset after age five.
- Exclusion of children with prior afebrile seizures.
- Outcome assessment via cross-sectional survey with 1-13 year follow-up.
- Analysis of clinical data, electroencephalographic (EEG) abnormalities, and family history.
Main Results:
- Most children (40/50) had two or fewer late-onset febrile seizures, with cessation by age ten.
- Twenty children experienced complex febrile seizures; 16 had a family history of febrile seizures.
- Five children developed afebrile seizures; 18 had educational difficulties.
- EEG abnormalities were present in 22 children but did not predict future afebrile seizures.
Conclusions:
- Febrile seizures occurring after age five are infrequent, typically cease by age ten, and have a low recurrence rate.
- The risk of developing afebrile seizures following late-onset febrile seizures is small.
- Educational difficulties can occur but are not directly predicted by EEG findings in this cohort.
Abstract:
This retrospective study documents the clinical features, electroencephalographic data, and outcome of 50 children with a history of seizures with fever that occurred after 5 years of age. Children with afebrile seizures before the onset of febrile seizures were excluded. Outcome was based on a cross-sectional survey and the follow-up period was 1-13 years. Of the 50 children, 40 had two or fewer febrile seizures after 5 years of age, and febrile seizures did not occur after 10 years of age. Twenty had complex febrile seizures, and 16 had a first-degree relative with febrile seizures. Five developed afebrile seizures, and 18 had educational difficulties. Epileptiform electroencephalographic abnormalities were observed in 22 but were not predictive of later afebrile seizures. Febrile seizures that occur after 5 years of age recur infrequently and cease by 10 years of age. The risk of developing afebrile seizures in this group is small.