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Febrile convulsions increase risk of Tourette syndrome
Yi-Fang Tu1, Cheng-Li Lin2, Chih-Hao Lin3
1Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Insights
Febrile convulsion (FC) may increase the risk of developing Tourette syndrome (TS) in children. Frequent medical visits for FC indicate a higher vulnerability to TS development.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Epidemiology
Background:
- Febrile convulsion (FC) and Tourette syndrome (TS) are common childhood neurological disorders.
- Both conditions share clinical similarities including paroxysmal symptoms and normal neurodevelopment.
- Understanding potential links is crucial for early identification and management.
Purpose of the Study:
- To investigate the association between febrile convulsion (FC) and the subsequent development of Tourette syndrome (TS) in children.
- To identify risk factors for TS in children with a history of FC.
- To explore the impact of FC-related healthcare utilization on TS risk.
Main Methods:
- Retrospective cohort study using the Taiwan National Health Insurance Research Database.
- 1586 patients with FC were compared to 6344 matched controls without FC.
- Cox proportional hazard regression models were employed to assess TS risk.
Main Results:
- The incidence of TS was significantly higher in the FC cohort (28.5 per 10,000 person-years) compared to the non-FC cohort (13.9 per 10,000 person-years).
- Adjusted hazard ratio for TS in FC patients was 1.91 (95% CI=1.32-2.75).
- Risk factors included male sex, rural residence, and parental blue-collar occupation; increased FC visit frequency correlated with higher TS risk (trend test P<0.0001).
Conclusions:
- Febrile convulsion (FC) is associated with an increased risk of subsequent Tourette syndrome (TS) in children.
- Children experiencing frequent medical visits for FC are particularly vulnerable to developing TS.
- Findings highlight the importance of monitoring children with FC for TS symptoms.
Purpose:
Febrile convulsion (FC) and Tourette syndrome (TS) are both common neurological disorders in infants and children. Both disorders share clinical similarities, such as paroxysmal symptoms with normal neurodevelopment and expected remission over time. This population-based study investigated the association between FC with TS during childhood neurodevelopment.
Method:
We used the Taiwan National Health Insurance Research Database to conduct a retrospective cohort analysis on 1586 FC patients. A reference cohort of 6344 non-FC patients, matched for age, sex, urbanization level, parental occupation, and index year, was used for comparison. The risk of the occurrence of TS in FC patients was assessed using a Cox proportional hazard regression model.
Results:
The overall incidence of TS was higher in the FC cohort than in the non-FC cohort (28.5 vs 13.9 per 10,000 person-years; adjusted hazard ratio=1.91, 95% confidence interval=1.32-2.75). The associated risk factors for FC patients to develop TS were boys, children living in rural areas, and children whose parents held blue-collar positions. Moreover, the risk of TS in FC patients rose from 0.89 to 16.0 (trend test P<0.0001) when the frequency of FC-related medical visits increased from 1 to 2 times to more than 4 times. The adjusted hazard ratio for TS in related to FC-related medical visits was 1.02 (95% CI=1.02-1.03) per one frequency increment.
Conclusion:
FC may increase the risk of subsequent TS occurrence in children. Children who had frequent medical visits for FC were particularly vulnerable.
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