Related Experiment Videos
Frequent febrile episodes and recurrent febrile convulsions
1Department of Pediatrics, Glostrup University Hospital, Copenhagen, Denmark.
Insights
Children experiencing frequent febrile episodes (≥4 per year) have a significantly higher risk of recurrent febrile convulsions. Prophylaxis reduced recurrence, but frequent feverish illnesses remained the strongest predictor of further febrile fits.
Area of Science:
- Pediatrics
- Neurology
Background:
- Recurrent febrile convulsions are a concern in childhood.
- Identifying predictors of recurrence is crucial for management.
Purpose of the Study:
- To investigate the relationship between the frequency of febrile episodes and the recurrence of febrile convulsions.
- To evaluate the efficacy of short-term diazepam prophylaxis in preventing recurrent febrile convulsions.
Main Methods:
- Prospective study of 289 children post-first febrile seizure.
- Randomization to diazepam prophylaxis or no prophylaxis.
- 18-month follow-up period.
Main Results:
- Children with ≥4 febrile episodes/year had a 78% recurrence rate without prophylaxis vs. 17% with <4 episodes/year.
- Frequent febrile episodes were the strongest predictor of recurrence (P<0.0001).
- Diazepam prophylaxis reduced recurrence rates in both groups.
Conclusions:
- The number of febrile episodes is a significant predictor of recurrent febrile convulsions.
- Early-onset febrile seizures and frequent febrile illnesses increase the risk of recurrence.
- Diazepam prophylaxis can reduce recurrence, but managing frequent febrile episodes is key.
Abstract:
The relationship between the number of febrile episodes and recurrent febrile convulsions was studied prospectively in 289 children after their first febrile seizure. They were randomized to either short-term diazepam prophylaxis (n = 152) or to no prophylaxis (n = 137), and followed for 18 months. Among untreated children with many subsequent febrile episodes (greater than or equal to 4 per year) 29 of 37 (78%) had a recurrence vs. 17 of 100 (17%) with only few (less than 4 per year) feverish illnesses. The former group had a 4:1 chance of developing further febrile fits, compared with a 1:4 chance in the latter (P less than 0.0001). A similar pattern was observed in the prophylaxis group, but less recurrences were seen (30% vs. 6%, P less than 0.0001). By Cox regression analysis, the subsequent occurrence of many febrile episodes could be identified among several items, including young age at onset, as the adverse factor most highly associated with further febrile fits (P less than 0.0001).