Predictors of unprovoked seizure after febrile seizure: short-term outcomes

We performed this study to confirm the known risk factors and to identify possible new risk factors for subsequent unprovoked seizure after febrile seizure (FS) on Jeju Island, South Korea.

A population-based retrospective study of 204 children with FS, whose first FS developed between March 2003 and August 2011, and who were seen in the Pediatric Department at the Jeju National University Hospital.

Two hundred four children (136 boys and 68 girls) were enrolled in this study. Simple FS was found in 107 children, and complex FS was found in 97 children. The average age at the first FS was 18.9 months. The average total number of FSs was 4.3. A family history of FS or epilepsy was found in 29.4% and 7.8% of patients, respectively. Abnormal findings of EEG were observed in 35.8%. Complex features in the first FS were noted in 28.9%. Subsequent unprovoked seizures occurred in 23.0%. Univariate analysis showed that low parental educational level was one of several variables that were significantly related to unprovoked seizure. Parental educational level was not included in the multivariate model because of an insufficient sample size. Multivariate analysis identified the following factors as significant predictors of unprovoked seizure: late onset of FS at age>3 years, complex features in the first FS, family history of epilepsy, and abnormal findings on EEG, and FS developed at a body temperature of <39°C.

We confirmed the known risk factors for subsequent unprovoked seizure and found that low parental educational status may be a new prognostic indicator. However, further investigation using larger populations and a prospective design is needed to confirm that this is a valid prognostic factor for FS.