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Risk factors for secondary epilepsy following febrile seizures in children: A meta-analysis
Jing Zhang1, Qiaomei Jing2, Shangbin Li2
1Department of Neurology, First Affifiliated Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang 050000, China.
Insights
Identifying risk factors for secondary epilepsy in children with febrile seizures (FS) is crucial. Preterm birth, perinatal asphyxia, early seizure onset, and abnormal EEG/imaging are key risk factors for developing epilepsy after FS.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Genetics
Background:
- Febrile seizures (FS) are common in children.
- A subset of children with FS develop epilepsy.
- Early identification of risk factors is vital for intervention.
Purpose of the Study:
- To systematically assess risk factors for secondary epilepsy in children with febrile seizures.
- To provide a foundation for timely clinical intervention and improved prognosis.
Main Methods:
- Comprehensive literature search across multiple databases (PubMed, Embase, Web of Science, etc.) up to October 2023.
- Meta-analysis of 23 studies involving 714 cases and 5269 controls.
- Statistical analysis performed using Stata 15.0.
Main Results:
- Significant risk factors identified include preterm birth, perinatal asphyxia, early age at first seizure (<12 months), low peak temperature (<39°C), and rapid onset of seizure after fever.
- Complex febrile seizures (FS), prolonged duration (>15 min), multiple seizures, focal seizures, recurrent FS (≥2), neurodevelopmental abnormalities, and developmental delay are associated with increased epilepsy risk.
- Family history of epilepsy or FS, abnormal electroencephalogram (EEG), and brain imaging abnormalities are also significant risk factors.
Conclusions:
- This meta-analysis systematically identifies key risk factors for secondary epilepsy following febrile seizures in children.
- Intervention strategies should target modifiable risk factors.
- High-risk children, regardless of modifiable factors, require early detection and continuous follow-up to mitigate epilepsy risk.
Objective:
To systematically assess the risk factors for secondary epilepsy in children with febrile seizures, in order to promptly identify early signs of epilepsy and establish a reliable foundation for timely clinical intervention and improved prognosis.
Methods:
The databases, including CNKI, WanFang, VIP, CBM, PubMed, Embase, Web of Science, and the Cochrane Library were searched for relevant studies, up to October 2023. Two researchers independently collected and extracted data from selected studies, adhering to predefined criteria. Statistical analysis was performed using Stata 15.0.
Results:
A total of 23 studies included 714 cases in the case group and 5269 cases in the control group. The results of Meta-analysis showed that preterm birth (OR=3.30, P=0.02), history of perinatal asphyxia (OR=3.94, P=0.001), age at the first seizure < 12 months (OR=2.93, P=0.003), peak temperature < 39℃ (OR=2.51, P<0.001), onset of fever to seizure < 1 h (OR=5.61, P<0.001), Complex FS(OR=4.08, P<0.001), duration of the seizure > 15 min (OR=6.21, P<0.001), Multiple seizures (≥2/episode) in one attack (OR=2.92, P<0.001), focal seizures (OR=2.53, P=0.018), recurrent FS (≥2) (OR=3.49, P<0.001), neurodevelopmental abnormality(OR=8.68, P<0.001), developmental delay(OR=10.04, P<0.001), family history of epilepsy (OR=2.74, P=0.004), family history of FS (OR=2.07, P=0.022), electroencephalogram (EEG) abnormal(OR=4.06, P<0.001)and Brain imaging abnormalities (OR=2.84, P=0.002)were Risk factors for secondary epilepsy following FS in Children. Notably, gender (female) was not a significant factor.
Conclusions:
This study provides a comprehensive and systematic discussion of the risk factors associated with secondary epilepsy in children with febrile seizures. It actively formulates intervention measures for modifiable risk factors and conducts early detection and continuous follow-up observation for non-modifiable high-risk children, thereby reducing the risk of epilepsy.
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