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Prediction of febrile seizures in siblings: a practical approach
A van Esch1, E W Steyerberg, C M van Duijn
1Department of Paediatrics, Academic Hospital Rotterdam, Sophia Children's Hospital, The Netherlands.
Insights
Children with febrile seizures (FS) have an increased risk of FS in their siblings. A predictive model using parental history, early onset, and proband recurrence can estimate sibling FS risk.
Area of Science:
- Pediatrics
- Genetics
- Neurology
Background:
- Febrile seizures (FS) are common in childhood.
- Genetic predisposition plays a role in FS.
- Quantifying familial risk is crucial for risk assessment.
Purpose of the Study:
- To determine the cumulative risk of FS in first-degree relatives of children with FS.
- To develop a predictive model for FS risk in siblings.
Main Methods:
- Prospective follow-up study of 129 children with FS.
- Calculation of cumulative FS risks in parents and siblings.
- Development of a multivariable prediction model.
Main Results:
- A 6-year cumulative FS risk of 7% was observed in relatives.
- Risk was higher (12%) in relatives of children with recurrent FS.
- Sibling FS risk (10%) was double the general population risk (4%).
- A model incorporating parental history, early onset, and proband recurrence predicted 46% risk in siblings with multiple factors.
Conclusions:
- The risk of FS is elevated in siblings of children diagnosed with FS.
- A practical prediction model using three key risk factors can estimate age-attained FS risk in siblings.
Unlabelled:
To quantify the risk of febrile seizures (FS) in relatives of children with FS and to predict the risk of FS in siblings, we calculated cumulative risks of FS in first degree relatives of 129 children with FS. The study was conducted as a prospective follow up study of FS recurrences at the outpatient clinic of the Sophia Children's Hospital in Rotterdam. Thirteen parents and 12 siblings had experienced FS, accounting for a 6-year cumulative risk of 7%. The risk of FS was increased in relatives of children with recurrent FS (12%). The risk of FS in siblings (10%) in our study was more than twice the average risk in a similar population (4%). A positive FS history in a parent, young age at onset in the proband, and recurrences in the proband were selected in a multivariable prediction model. If two or more of these risk factors were present, the risk of West European siblings to develop FS was 46% (hazard ratio 5.4).
Conclusion:
The cumulative risk of FS in siblings of children with FS is increased. The age attained risk of FS can be estimated using a practical model incorporating three readily available risk factors.