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What types of epilepsy are preceded by febrile seizures? A population-based study of children
P Camfield1, C Camfield, K Gordon
1Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Febrile seizures often precede generalized tonic-clonic epilepsy. Prolonged febrile seizures rarely lead to intractable complex partial seizures, suggesting a link to individual seizure thresholds.
Area of Science:
- Neurology
- Pediatric Neurology
- Epileptology
Background:
- Febrile seizures are common in childhood.
- Understanding the long-term epilepsy risk following febrile seizures is crucial.
- The relationship between febrile seizure characteristics and subsequent afebrile seizure types requires further investigation.
Purpose of the Study:
- To investigate the association between preceding febrile seizures and the development of specific afebrile seizure types in children.
- To determine if prolonged febrile seizures are linked to intractable epilepsy, particularly complex partial seizures.
- To explore the febrile seizure tendency as a potential marker for an individual's seizure threshold.
Main Methods:
- Retrospective review of pediatric electroencephalograms (EEGs) from 1977-1985.
- Identification of 504 children with epilepsy onset during the study period.
- Analysis of seizure history, including preceding febrile seizures and subsequent afebrile seizure types, with an average follow-up of 85 months.
Main Results:
- 14.9% of children with epilepsy had a history of febrile seizures.
- Febrile seizures were most commonly followed by generalized tonic-clonic afebrile seizures (22%).
- Prolonged febrile seizures were rarely associated with idiopathic intractable complex partial seizures (2 out of 17 cases).
Conclusions:
- Febrile seizures are a significant precursor to generalized tonic-clonic afebrile seizures.
- Prolonged febrile seizures have a low association with the development of intractable complex partial seizures.
- A tendency for febrile seizures may indicate an individual's underlying seizure susceptibility or threshold.
Abstract:
In a population of 850,000, the authors studied afebrile seizures that follow febrile seizures. Review of all paediatric EEGs identified 504 children with epilepsy beginning between 1977 and 1985. Follow-up averaged 85 months. 14.9 per cent had preceding febrile seizures: 13 per cent complex partial, 13 per cent partial/secondary generalized and 22 per cent generalized tonic-clonic. The rate of preceding febrile seizures did not vary with the cause of epilepsy. Prolonged febrile seizures were not associated with any particular afebrile seizure type. Of 17 with preceding prolonged febrile seizures, seven developed intractable epilepsy: 17.9 per cent of the total intractable cases. Only two developed idiopathic intractable complex partial seizures after prolonged febrile seizures. The authors conclude that febrile seizures most often precede generalized tonic-clonic afebrile seizures. Prolonged febrile seizures rarely precede idiopathic intractable complex partial seizures. The febrile seizure tendency may be a fundamental marker of an individual's seizure threshold.