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Long-term outcome of children with febrile seizures

W L Lee1

  • 1Department of Neurology, Tan Tock Seng Hospital, Singapore.

Insights

Long-term follow-up of febrile seizures (FS) in Singaporean children shows no deaths or permanent neurological deficits. However, prolonged FS and family history of epilepsy increase the risk of subsequent afebrile seizures (AFS).

Area of Science:

  • Pediatrics
  • Neurology
  • Epidemiology

Background:

  • Febrile seizures (FS) are common in childhood.
  • Understanding the long-term outcomes of FS is crucial for clinical management and parental counseling.

Purpose of the Study:

  • To investigate the long-term outcomes of children hospitalized for febrile seizures in Singapore.
  • To identify risk factors for subsequent afebrile seizures (AFS) and epilepsy after an initial FS.

Main Methods:

  • Retrospective analysis of medical records of 479 children admitted for FS between 1981-1982.
  • Follow-up conducted in 1988 to assess neurological outcomes, occurrence of AFS, and epilepsy.
  • Statistical analysis to determine predictors of AFS and epilepsy.

Main Results:

  • No deaths or permanent neurological deficits were observed in the 476 children followed up.
  • The incidence of epilepsy was 1.0%.
  • Children with FS lasting ≥30 minutes had a significantly higher incidence of unprovoked AFS (12.1%) compared to those with FS <30 minutes (1.4%).
  • A family history of epilepsy or fits was associated with an increased risk of AFS (9.1%) compared to no family history or FS-only history (1.6%).
  • Sex, race, age of onset, recurrent FS, and EEG findings were not significant predictors.

Conclusions:

  • Febrile seizures in this cohort had a benign long-term outcome with no permanent neurological deficits.
  • Prolonged febrile seizures and a family history of epilepsy are significant risk factors for subsequent afebrile seizures.
  • Epilepsy developed in a small proportion of children following febrile seizures.

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