Risk of epilepsy after febrile convulsions: a national cohort study
1Department of Paediatrics, Addenbrooke's Hospital, Cambridge.
Insights
The risk of developing epilepsy after febrile convulsions is lower than previously thought, especially for simple febrile seizures in children. Complex febrile convulsions, particularly focal ones, carry a higher risk of subsequent epilepsy.
Area of Science:
- Pediatric Neurology
- Epileptology
Background:
- Febrile convulsions are common in childhood.
- Understanding the long-term risks, such as epilepsy, is crucial for clinical management.
Purpose of the Study:
- To identify children experiencing febrile convulsions.
- Classify these events as simple or complex.
- Determine the incidence and type of subsequent afebrile seizures.
Main Methods:
- A national population-based study in the United Kingdom.
- Followed 16,004 neonatal survivors from birth.
- Data collected via questionnaires at 5 and 10 years and hospital records.
Main Results:
- 2.7% of 14,676 children experienced febrile convulsions.
- Epilepsy developed in 9 out of 382 children with febrile convulsions.
- Higher epilepsy risk observed in complex (6/95) versus simple (3/287) febrile convulsions, and highest in focal febrile convulsions (5/17).
Conclusions:
- The incidence of epilepsy following febrile convulsions is lower than often reported in hospital-based studies.
- Brain damage leading to epilepsy as a consequence of febrile convulsions appears to be rare.
Objective:
To identify children with febrile convulsions, classify their febrile convulsions into simple and complex, and determine the number and type of subsequent afebrile seizures in those children.
Design:
National population based study.
Setting:
United Kingdom.
Subjects:
16,004 neonatal survivors born during one week in April 1970.
Main Outcome Measures:
Information about febrile and afebrile seizures obtained from questionnaires at 5 and 10 years of age and from hospital records.
Results:
Information was available for 14,676 of the cohort children. 398 (2.7%) of them had had at least one febrile convulsion. 16 children were known to be neurologically or developmentally abnormal before the first attack. Of the remaining 382 children, 305 had had a simple first febrile convulsion and 77 a complex first febrile convulsion. Thirteen of the 382 had had one or more afebrile seizures, nine of whom had developed epilepsy (recurrent afebrile seizures). A higher proportion of children with complex febrile convulsions (6/95) rather than simple febrile convulsions (3/287) developed epilepsy, the risk being highest for those who had had focal febrile convulsions (5/17; chi 2 = 39.9, p less than 0.001). Three of the 32 children who had prolonged febrile convulsions developed afebrile complex partial seizures.
Conclusions:
The risk of epilepsy after febrile convulsions is much less than reported in many hospital studies, and if febrile convulsions cause brain damage that leads to later epilepsy this is a rare occurrence.
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