Febrile Seizures in an App-Based Children's Fever Registry: Mixed Methods Study

Febrile seizures, although typically benign, can cause significant emotional distress for parents. Their diverse etiological risk factors underscore the need for further research. Ecological momentary assessment (EMA) offers a cost-effective and timely method for real-time data collection. The FeverApp, an EMA-based registry for fever management, enables parents to document febrile seizures as they occur.

This study systematically investigates febrile seizure records from the FeverApp registry to assess their characteristics and explore the clinical implications of the findings. By providing real-world data on seizure management, this research demonstrates the potential of app-based EMA in pediatric care. Additionally, it offers insights for targeted interventions and improved febrile seizure management.

We used a mixed methods approach. A descriptive qualitative analysis of parental descriptions of 226 seizures belonging to 161 children was conducted. Additionally, a comparative quantitative analysis of group differences was assessed through matched-pair sampling, comparing 114 children. Statistical methods were tailored to the nature of the respective variables, which included prevalence, age, gender, health and febrile history, fever management, temperature, well-being, and parental confidence.

Qualitative analyses provided detailed descriptions of seizure symptoms, seizure duration, and seizure management practices. Additionally, the data revealed a high rate of emergency consultations related to febrile seizures. However, there was underreporting of febrile seizures within the FeverApp, with a reported incidence of only 0.4% among febrile children. In a matched sample controlled for gender and age, significant differences were observed between febrile children with and those without febrile seizures in several parameters, including maximum recorded temperature (P<.001), prevalence of chronic diseases (P=.004), parental confidence (P=.01), and frequency of emergency consultations (P<.001).

This study offers valuable insights into the characteristics, temporal dynamics, management strategies, and parental responses to febrile seizures in children. Despite the limitation of potential underreporting in an EMA-based registry, the findings highlight the critical importance of parental education and support in managing febrile seizures. Enhancing these areas has the potential to reduce unnecessary medical consultations and improve the overall care of affected children. Furthermore, integrating improvements in the FeverApp's education and documentation system regarding febrile seizures could facilitate better management and support future research efforts.