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Family history and recurrence of febrile seizures
A van Esch1, E W Steyerberg, M Y Berger
1Department of Pediatrics, Academic Hospital, Rotterdam, The Netherlands.
Insights
A detailed family history significantly increases the risk of febrile seizure recurrence. Specifically, having a first-degree relative with febrile seizures more than doubles a child's recurrence risk.
Area of Science:
- Pediatrics
- Genetics
- Neurology
Background:
- Febrile seizures affect a significant number of children.
- Predicting recurrence risk is crucial for clinical management.
- Family history is a known risk factor, but its detailed impact requires further investigation.
Purpose of the Study:
- To evaluate the predictive value of detailed family history in assessing febrile seizure recurrence risk.
- To quantify the association between the proportion of affected first-degree relatives and recurrence risk.
Main Methods:
- Prospective study of 115 children presenting with febrile seizures.
- Analysis using Kaplan-Meier estimates and Cox proportional hazard models.
- Assessment of recurrence risk based on first- and second-degree family history.
Main Results:
- A first-degree family history (parents or siblings) increased the two-year recurrence risk from 27% to 52%.
- No significant increase in recurrence risk was observed with second-degree relatives alone.
- Recurrence risk correlated significantly with the proportion of affected first-degree relatives (27%, 40%, and 83% for proportions of 0, 0-0.5, and >=0.5, respectively).
Conclusions:
- Detailed family history, particularly the proportion of affected first-degree relatives, provides a more refined assessment of febrile seizure recurrence risk.
- Focusing on first-degree relatives is key for accurate risk stratification.
- This detailed approach can aid in clinical decision-making for managing febrile seizures.
Abstract:
To determine the value of a detailed family history for the assessment of the risk of recurrence of febrile seizures, 115 children who visited the emergency room of an academic children's hospital were studied prospectively. The recurrence risk of febrile seizures was analysed in relation to the child's family history and the proportion of relatives affected by febrile seizures using Kaplan-Meier estimates and Cox proportional hazard models. A first degree family history positive for febrile seizures (parents or siblings affected by febrile seizures) increased a child's two year recurrence risk from 27 to 52%. No significant increase of recurrence risk for febrile seizures was found in children with second degree relatives (grandparents and uncles/aunts) or cousins only affected by febrile seizures. Recurrence risk was significantly correlated with the proportion of first degree relatives affected by febrile seizures: risks were 27, 40, and 83% in children whose proportion was 0, 0-0.5, and > or = 0.5 respectively. Analysis of the recurrence risk in relation to a weighted proportion, adjusted for the attained age and sex of first degree relatives, showed similar results. It is concluded that the application of the proportion of first degree relatives affected by febrile seizures generates a more differentiated assessment of the recurrence risk of febrile seizures.