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Long-term intellectual and behavioral outcomes of children with febrile convulsions
C M Verity1, R Greenwood, J Golding
1Department of Paediatrics, Addenbrooke's Hospital, Cambridge, United Kingdom.
Insights
Children experiencing febrile convulsions generally have normal academic progress, intelligence, and behavior at age 10. This population-based study found no significant long-term neurodevelopmental differences in children with febrile seizures.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Epidemiology
Background:
- Hospital-based studies suggested negative neurodevelopmental outcomes for children with febrile convulsions.
- Population-based studies indicated a potentially better prognosis.
Purpose of the Study:
- To investigate the long-term academic, intellectual, and behavioral outcomes of children with febrile convulsions.
- To compare outcomes between children with simple and complex febrile convulsions and the general cohort.
Main Methods:
- Utilized data from the national population-based Child Health and Education Study in the UK.
- Assessed 381 children with febrile convulsions (simple and complex) at age 10 using standardized tests and questionnaires.
- Compared outcomes with a control group from the same cohort.
Main Results:
- No significant differences in academic progress, intelligence, or behavior were found between children with febrile convulsions and controls at age 10.
- Outcomes were similar for children with simple and complex febrile convulsions, and for those with single versus recurrent episodes.
- A small but significant increase in special schooling was noted for children experiencing febrile convulsions in their first year of life.
Conclusions:
- Febrile convulsions do not appear to negatively impact overall academic progress, intellect, or behavior at age 10 in a population-based setting.
- While early-onset febrile convulsions warrant monitoring, the majority of children experience typical development.
Background:
Hospital-based studies have reported that children with febrile convulsions have subsequent mental retardation and behavior problems. In contrast, population-based studies have reported a better outcome.
Methods:
We identified 398 children with febrile convulsions among 14,676 children enrolled in the Child Health and Education Study, a national population-based study in the United Kingdom of children born in one week in April 1970. The children were comprehensively assessed at the age of 10. After excluding 16 children who had neurodevelopmental problems before their first febrile convulsion and 1 child whose case was atypical, we studied 381 children, 287 with simple febrile convulsions and 94 with complex febrile convulsions. We compared them with the rest of the cohort using measures of academic progress, intelligence, and behavior that included questionnaires, standardized tests, and formal tests.
Results:
At the 10-year assessment, only 4 of 102 measures of academic progress, intelligence, and behavior differed significantly between the entire group of children with febrile convulsions and the group without febrile convulsions -- no more than would be expected by chance. Similar results were found when children with simple febrile convulsions and those with complex febrile convulsions were analyzed separately. The children with recurrent episodes of febrile convulsions had outcomes similar to those of the children with only one episode each. Special schooling was required for more children who had febrile convulsions in the first year of life than for those who had had them later in life (5 of 67, or 7.5 percent, vs. 4 of 265, or 1.5 percent; P=0.02), but these numbers were small.
Conclusion:
Children who had febrile convulsions performed as well as other children in terms of their academic progress, intellect, and behavior at 10 years of age.
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