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Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures
Alja Kavčič1, Zvonka Rener-Primec1,2
11 Faculty of Medicine, University of Ljubljana, Slovenia.
Insights
Epileptiform discharges on electroencephalography (EEG) have low predictive value for epilepsy after simple febrile seizures but are more indicative after complex or recurrent febrile seizures. Normal EEGs suggest a low risk of developing epilepsy.
Area of Science:
- Neurology
- Pediatrics
- Clinical Neurophysiology
Background:
- Febrile seizures are common in childhood.
- Predicting subsequent epilepsy risk is crucial for management.
- Epileptiform discharges on electroencephalography (EEG) are potential biomarkers.
Purpose of the Study:
- To evaluate the predictive value of epileptiform discharges for epilepsy development after febrile seizures.
- To differentiate risk based on febrile seizure type (simple vs. complex) and EEG findings.
Main Methods:
- Retrospective study of 140 children with febrile seizures.
- EEG performed in 103 children, analyzing epileptiform patterns.
- Follow-up to determine epilepsy development.
Main Results:
- Epilepsy developed in 10 children; 9 had epileptiform EEGs.
- Normal EEGs after complex or recurrent febrile seizures showed a very low risk of epilepsy.
- Epileptiform EEGs had a 15% positive predictive value in complex and 31% in recurrent febrile seizures.
Conclusions:
- Normal EEGs after febrile seizures indicate a low likelihood of developing epilepsy.
- Epileptiform discharges are more predictive of epilepsy in recurrent febrile seizures than in complex ones.
Abstract:
The predictive value of epileptiform discharges for subsequent epilepsy after febrile seizures was studied in 140 children: 72 children (51%) had simple febrile seizures and 68 children (49%) had complex febrile seizures. Electroencephalography (EEG) was performed in 103 children (74%), it was normal in 66 (47%) and with epileptiform patterns in 37 patients (26%). At follow-up in 2017, 10 children developed epilepsy, 1 had a single epileptic seizure, 9 of them had epileptiform EEGs. Of the patients with normal EEGs after complex febrile seizures, none developed epilepsy, and 92% of patients with normal EEGs after recurrent febrile seizures did not develop epilepsy. Therefore, patients with normal EEGs were unlikely to develop epilepsy. Fifteen percent of patients with complex and 31% of patients with recurrent febrile seizures and epileptiform EEGs developed epileptic seizures. The positive predictive value of epileptiform discharges was low in complex and twice as high in recurrent febrile seizures.
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