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Predictors of epilepsy in children who have experienced febrile seizures
Insights
Epilepsy developed in 2% of children after febrile seizures. Prior neurological status and complex first seizures significantly increased epilepsy risk in children.
Area of Science:
- Pediatrics
- Neurology
- Epileptology
Background:
- Febrile seizures are common in childhood.
- Predicting the development of epilepsy after febrile seizures is crucial for early intervention.
Purpose of the Study:
- To determine the incidence of epilepsy following febrile seizures.
- To identify risk factors for epilepsy development after febrile seizures.
Main Methods:
- A cohort of 1706 children with at least one febrile seizure was followed until age seven.
- Neurologic/developmental status and first febrile seizure characteristics were assessed.
Main Results:
- Epilepsy developed in 2% of children by age seven.
- Children with abnormal pre-seizure status and complex first seizures had an 18-fold higher epilepsy risk.
- Even children with normal status and non-complex first seizures showed a slightly increased epilepsy risk.
Conclusions:
- Prior neurological status and first seizure complexity are key predictors of epilepsy post-febrile seizure.
- Risk stratification can aid in managing children with a history of febrile seizures.
Abstract:
We examined the frequency of development of afebrile seizures in 1706 children who had experienced at least one febrile seizure and were followed to the age of seven years. Epilepsy developed by seven years of age in 20 per 1000 (2 per cent), and another 10 per 1000 had at least one afebrile seizure that did not meet our definition of epilepsy. In children whose neurologic or developmental status was suspect or abnormal before any seizure and whose first seizure was complex (longer than 15 minutes, multiple or focal) epilepsy developed at a rate 18 times higher than in children with no febrile seizures (92 vs. 5 per 1000; P less than 0.001). In the largest group with febrile seizures, those previously normal with noncomplex first febrile seizures, epilepsy developed in 11 per 1000; this rate, although moderate, was greater than that for children with no febrile seizures (P = 0.027). Prior neurologic and developmental status and characteristics of the first febrile seizure are important predictors of epilepsy after febrile seizures.