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Seizure recurrence after a first febrile convulsion
1Department of Paediatrics, King Fahad Hofuf Hospital, Al-Hassa, Saudi Arabia.
Insights
Recurrent febrile convulsions in children are linked to younger age, complex initial seizures, and family history. High fever may reduce recurrence risk. Anticonvulsant prophylaxis is suggested for complex febrile seizures.
Area of Science:
- Pediatrics
- Neurology
Background:
- Febrile convulsions are common in childhood.
- Identifying risk factors for recurrence is crucial for management.
Purpose of the Study:
- To identify risk factors associated with recurrent febrile convulsions in children.
- To evaluate the association between initial febrile convulsion characteristics and recurrence.
Main Methods:
- Retrospective study of 140 children aged 6 months to 6 years with a first febrile convulsion.
- Data collected from medical records over a 3-year period.
- Statistical analysis to determine risk factors for recurrence.
Main Results:
- 43% of children experienced recurrent febrile convulsions.
- Risk factors for recurrence included age < 18 months, complex initial febrile convulsions, and family history of febrile convulsions.
- Higher temperature (>39°C) was associated with decreased recurrence risk.
- Afebrile convulsions were closely associated with seizure recurrence in children with complex febrile convulsions.
Conclusions:
- Younger age, complex initial febrile convulsions, and family history are significant predictors of recurrence.
- Anticonvulsant prophylaxis should be considered for children with complex febrile convulsions.
Abstract:
In this study, 140 children aged from 6 months to 6 years who presented with a first febrile convulsion at the King Fahad Hofuf Hospital, Al-Hassa, Saudi Arabia were retrospectively identified. Information about these children was obtained from their medical records covering a follow-up period of 3 years from July 1989 to June 1992. Recurrent febrile convulsions occurred in 60 of them (43%). Relevant risk factors that were observed to be significantly associated with seizure recurrence included an age of less than 18 months (odds ratio [OR] = 3.82; 95% confidence interval [CI] = 9.26, 1.58), an initial febrile convulsion that was complex (OR = 4.41; CI = 9.50, 2.05) and a positive family history of febrile convulsions (OR = 4.12; CI = 10.74; 1.58), while a decreased risk of recurrence occurred with a temperature of over 39 degrees C (OR = 4.60; CI = 9.44; 2.24). There was no association between seizure recurrence and the duration of the initial febrile convulsion (OR = 0.93; CI = 2.33; -2.04) or family history of epilepsy (OR = 0.88; CI = 4.22, -3.27). An important observation in the present study is the close association (ORM-H = 2.36; X2M-H = 9.65) between the development of an afebrile convulsion and seizure recurrence among the group of children with CFC. Anticonvulsant prophylaxis should therefore be considered for children whose initial febrile convulsions are complex in nature.