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Febrile seizures: an epidemiological and outcome study of 482 cases

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Abstract

Introduction

Febrile seizures (FSs) are the most common type of seizures seen in children. After the first FS, 3 to 12 % of children develop epilepsy, and 30 % of these patients present with recurrent FS. The purpose of this study was to describe the epidemiological aspects of FS in order to better define the long-term outcomes in children with first FS and to identify the risk factors associated with the recurrence of FS as well as the development of epilepsy.

Methods

A retrospective study of 482 children with FS was conducted from January of 2004 to December of 2009 in the pediatric department of Hedi Chaker University Hospital in Sfax, Tunisia. The medical records for each patient were first collected and then analyzed at a later time.

Results

The study included 482 children. Simple FSs were found in 55.2 % of children, and complex FSs were observed in 44.8 %. The mean duration for follow-up examinations was 2 years and 4 months, and ranged from 1 to 5 years. No deaths or permanent neurological deficits due to FSs were observed, and only six children (1 %) developed epilepsy. A total of 57 children (11.7 %) developed recurrent seizures. Our findings suggest that a family history of FS, young age at onset, and a low degree of fever were predictive of recurrent FSs.

Conclusion

Children with FSs encounter a minor risk of mortality and morbidity. While recurrent seizures are observed in these children, only a minority of these patients develop epilepsy.

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References

  1. Fetveit A (2008) Assessment of febrile seizures in children. Eur J Pediatr 167:17–27

    Article  PubMed  Google Scholar 

  2. Hauser WA (1994) The prevalence and incidence of convulsive disorders in children. Epilepsia 35(2):S1–S6

    Article  PubMed  Google Scholar 

  3. Freeman JM (1980) Febrile seizures: a consensus of their significance, evaluation, and treatment. Pediatrics 66:1009

    PubMed  CAS  Google Scholar 

  4. Anonymous (1993) Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis, International League against Epilepsy. Epilepsia 4:592–596

    Google Scholar 

  5. Waruiru C, Appleton R (2004) Febrile seizures: an update. Arch Dis Child 89:751–756

    Article  PubMed  CAS  Google Scholar 

  6. Berg AT, Shinnar S (1996) Complex febrile seizures. Epilepsia 37:126–133

    Article  PubMed  CAS  Google Scholar 

  7. Ostergaard JR (2009) Febrile seizures. Acta Paediatr 98:771–773

    Article  PubMed  Google Scholar 

  8. Karande S (2007) Febrile seizures: a review for family physicians. Indian J Med Sci 61:161–172

    Article  PubMed  Google Scholar 

  9. Piperidou HN, Heliopoulos IN, Maltezos ES, Stathopoulos GA, Milonas IA (2002) Retrospective study of febrile seizures: subsequent electroencephalogram findings, unprovoked seizures and epilepsy in adolescents. J Int Med Res 30:560–565

    PubMed  CAS  Google Scholar 

  10. Singhi PD, Srinivas M (2001) Febrile seizures. Indian Pediatr 38:733–740

    PubMed  CAS  Google Scholar 

  11. Auvin S, Vallée L (2009) Febrile seizures: current understanding of pathophysiological mechanisms. Arch Pediatr 16:450–456

    Article  PubMed  CAS  Google Scholar 

  12. Motte J, Vallée L (2002) Diagnosis and treatment of febrile seizures. Epilepsies 14:89–94

    Google Scholar 

  13. Pedespan L (2007) Febrile seizures. Arch Pediatr 14:394–398

    Article  PubMed  CAS  Google Scholar 

  14. Carmant L (2002) Febrile convulsions in children. Le Clinicien 11:81–89

    Google Scholar 

  15. Dulac O (2007) Convulsions in children. Encycl Méd Chir Médecine d’urgence 25:140-G-20

    Google Scholar 

  16. Fohlen M (2008) Febrile convulsions. Encycl Méd Chir Traité de Médecine. doi:10.1016/S1634-6939(07)40085-0, 8–0762

  17. Camflied C, Camflied P (2005) Febrile convulsions. In: Roger J, Bureau M, Dravet C, Genton P, Tassinari C, Wolf P, Thomas P, Hirsch E (eds) Les syndromes épileptiques de l'enfant et de l'adolescent, 4th edn. John Libbey, Paris, pp 159–170

    Google Scholar 

  18. Verity CM, Butler NR, Golding J (1985) Febrile convulsions in a national cohort followed up from birth: prevalence and recurrence in the first five years of life. BMJ 290:1307–1310

    Article  PubMed  CAS  Google Scholar 

  19. Forsgren L, Sidenvall R, Blomquist HK, Heijbel J, Nyström L (1990) An incident case–referent study of febrile convulsions in children: genetical and social aspects. Neuropediatrics 21:153–9

    Article  PubMed  CAS  Google Scholar 

  20. Nabbout R (2008) Epilepsies faisant suite aux crises fébriles. Journées Parisiennes de Pédiatrie Medecine Diffusion Paris, pp 257–260

  21. Auvin S (2008) Crises fébriles de courte durée. Journées Parisiennes de Pédiatrie Medecine Diffusion Paris, pp 243–250

  22. Jones T, Jacobsen SJ (2007) Childhood febrile seizures: overview and implications. Int J Med Sci 4(2):110–114

    Article  PubMed  Google Scholar 

  23. American Academy of Pediatrics (2008) Febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics 21(6):1281–1286

    Google Scholar 

  24. Srinivasan J, Wallace KA, Scheffer IE (2005) Febrile seizures. Aust Fam Physician 34:1021–5

    PubMed  Google Scholar 

  25. Craig R, Warden G, Zibulewsky J, Mace S, Gold C, Gausche-Hill M (2003) Evaluation and management of febrile seizures in the out-of-hospital and emergency department settings. Ann Emerg Med 41:215–222

    Article  Google Scholar 

  26. Mamelle N, Mamelle JC, Plasse JC et al (1984) Prevention of recurrent febrile convulsions a randomized therapeutic assay: sodium valproate, phenobarbital and placebo. Neuropediatrics 15:37–42

    Article  PubMed  CAS  Google Scholar 

  27. Vining EP (1987) Cognitive dysfunction associated with antiepileptic drug therapy. Epilepsia 28:S18–S22

    Article  PubMed  Google Scholar 

  28. Rosman NP, Colton T, Labazzo J et al (1993) A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures. N Engl J Med 329:79–84

    Article  PubMed  CAS  Google Scholar 

  29. Dunlop S, Taitz J (2005) Retrospective review of the management of simple febrile convulsions at a tertiary paediatric institution. J Paediatr Child Health 41:647–651

    Article  PubMed  CAS  Google Scholar 

  30. Camfield PR, Camfield CS, Shapiro SH, Cummings C (1980) The first febrile seizure antipyretic instruction plus either phenobarbital or placebo to prevent recurrence. J Pediatr 97:16–21

    Article  PubMed  CAS  Google Scholar 

  31. Baumann RJ, Duffner PK (2000) Treatment of children with simple febrile seizure: the AAP practice parameter. Pediatr Neurol 23(1):11–7

    Article  PubMed  CAS  Google Scholar 

  32. (No authors listed) (1999) Practice parameter: long-term treatment of the child with simple febrile seizures. American Academy of Pediatrics. Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics 103:1307–1309

    Google Scholar 

  33. Steering Committee on Quality (2008) Improvement and management, subcommittee on febrile seizures American Academy of Pediatrics febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics 121(6):1281–6

    Article  Google Scholar 

  34. Marini C, Mei D, Temudo T, Ferrari AR, Buti D, Dravet C et al (2007) Idiopathic epilepsies with seizures precipitated by fever and SCN1A abnormalities. Epilepsia 48:1678–85

    Article  PubMed  CAS  Google Scholar 

  35. Shirts SB, Hauser WA, Annegers JF et al (1987) Risk of recurrence of febrile seizures in a population-based cohort of children, Rochester, Minnesota. Neurology 37(1):149

    Article  Google Scholar 

  36. El-Radhi AS, Withana K, Banajeh S (1986) Recurrence of febrile convulsions related to the degree of pyrexia during the first attack. Clin Pediatr 25:311–3

    Article  CAS  Google Scholar 

  37. Pavlidou E, Tzitiridou M, Kontopoulos E, Panteliadis CP (2008) Which factors determine febrile seizure recurrence? A prospective study. Brain Dev 30:7–13

    Article  PubMed  Google Scholar 

  38. Sugai K (2009) Current management of febrile seizures in Japan: an overview. Brain Dev 32:64–70

    Article  PubMed  Google Scholar 

  39. Berg AT, Shinnar S, Darefsky AS, Holford TR, Shapiro ED, Salomon M et al (1997) Predictors of recurrent febrile seizures: a prospective cohort study. Arch Pediatr Adolesc Med 151:371–8

    Article  PubMed  CAS  Google Scholar 

  40. Annegers JF et al (1987) Factors prognostic of unprovoked seizures after febrile convulsions. J Med 316:493–498

    CAS  Google Scholar 

  41. Verity CM, Golding J (1991) Risk of epilepsy after febrile convulsions: a national cohort study. BMJ 303:1373–6

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Lamia Sfaihi.

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Sfaihi, L., Maaloul, I., Kmiha, S. et al. Febrile seizures: an epidemiological and outcome study of 482 cases. Childs Nerv Syst 28, 1779–1784 (2012). https://doi.org/10.1007/s00381-012-1789-6

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  • DOI: https://doi.org/10.1007/s00381-012-1789-6

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