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Childhood-onset epilepsy with and without preceding febrile seizures
A T Berg1, S Shinnar, S R Levy
1Department of Biological Sciences, Northern Illinois Universisty, DeKalb 60115, UA.
Insights
Children with a history of febrile seizures were less likely to develop childhood absence epilepsy. A family history of febrile seizures suggests a genetic link, while complex febrile seizures indicate age-dependent susceptibility.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Genetics
Background:
- Febrile seizures precede epilepsy in 10-15% of children.
- Specific epilepsy types associated with febrile seizures are not well-understood.
Purpose of the Study:
- To identify distinct characteristics in children with epilepsy based on a history of preceding febrile seizures.
- To explore associations between febrile seizures and epilepsy characteristics.
Main Methods:
- Community-based prospective cohort study.
- Examined 524 children aged >=1 year at epilepsy onset.
- Analyzed seizure type, epilepsy syndrome, age at onset, etiology, and family history.
Main Results:
- 13.9% of children with epilepsy had prior febrile seizures.
- Febrile seizures associated with family history of febrile seizures.
- Less likely to have childhood absence epilepsy/absence seizures.
- Complex febrile seizures linked to younger epilepsy onset; no association with localization-related epilepsy.
Conclusions:
- Febrile seizures not specifically linked to temporal lobe or localization-related epilepsy.
- Family history suggests a genetic component for febrile seizures, particularly simple types.
- Complex febrile seizures suggest age-dependent susceptibility.
Objective:
To identify characteristics in children with epilepsy that differ between those who did versus did not have a history of preceding febrile seizures.
Background:
Febrile seizures precede epilepsy in 10 to 15% of children. Little is known about the specific types of epilepsy associated with febrile seizures.
Methods:
In a community-based, prospectively identified cohort of children, the association between prior febrile seizures and characteristics of the children's epilepsy (seizure type, epilepsy syndrome, age at onset, underlying etiology, family history) were examined for 524 of the children who were aged > or =1 year at onset of epilepsy.
Results:
Seventy-three (13.9%) had febrile seizures. Children with febrile seizures were more likely to have a first-degree or a second-higher-degree relative with febrile seizures and less likely to have childhood absence epilepsy and absence seizures compared with children without febrile seizures. This was especially true for simple febrile seizures. There was no specific association with localization-related forms of epilepsy. Complex, but not simple, febrile seizures were associated with younger age at onset of epilepsy. There was no evidence that focal or prolonged febrile seizures were associated with localization-related epilepsy or temporal lobe epilepsy per se. Of the three children whose initial MRIs demonstrated hippocampal atrophy, none had a history of febrile seizures.
Conclusions:
At the time of diagnosis, febrile seizures are not specifically related to temporal lobe epilepsy or localization-related epilepsy in general. A genetic component for febrile seizures is suggested by its positive associations with family history, especially for simple febrile seizures. Complex febrile seizures represent an underlying age-dependent susceptibility.