Febrile Seizures Research Articles

Manifestazioni parossistiche non epilettiche: tonic upgaze

A 2-year-old girl was hospitalized for suspected febrile seizures, but after a neurological reassessment, the episodes were classified as non-epileptic paroxysmal manifestations of the tonic upgaze type and required no treatment.

Risk factors of seizure and complex seizure in febrile children: a clinical study.

There is some evidence that trace element and mineral deficiencies may promote the occurrence of febrile seizures. However, the role of these elements in the occurrence of complex seizures in children with FS has not been comprehensively investigated. The present study was conducted to evaluate this issue. In a cross-sectional study, 220 patients including 110 febrile and 110 FS children aged 6-60 months were studied. Blood samples were taken and serum zinc, potassium, sodium, magnesium and calcium levels were measured. Demographic and clinical characteristics were also recorded. The patients were similar in age and sex. Higher serum zinc levels decreased the risk of seizure (RR = 0.95, p-value = 0.0001) and complex seizure (OR = 0.96, p-value = 0.03). Higher serum sodium levels decreased the risk of complex seizures (OR = 0.85, p-value = 0.023). Higher serum potassium levels were associated with a lower risk of seizure (OR = 0.55, p-value = 0.035). Serum calcium and magnesium levels were not associated with the risk of seizure and complex seizure. A BMI at the upper end of the normal range decreased the risk of complex seizures (OR = 0.83, p-value = 0.05). Male sex increased the risk of complex seizure (OR = 4.14, p-value = 0.016). Low serum levels of zinc, potassium and sodium are risk factors for seizure and complex seizure in febrile children. Male sex is also a risk factor for complex seizures. The time from fever to seizure was shorter in younger children. Children with a BMI at the upper end of the normal range have a lower risk of having a complex seizure.

Complex Febrile Seizures: Usual and the Unusual.

Febrile seizures account for 2 to 14% of all childhood seizures, and one-third of febrile seizures are complex febrile seizures. Despite this, there is a lack of clinical equipoise in the diagnosis and management of complex febrile seizures and this results in significant practice variability amongst physicians. Although febrile seizures are generally noted to be benign phenomenon, complex febrile seizures carry the risk of subsequent epilepsy. Furthermore, long-term neurodevelopmental sequelae have been observed in some cohorts. The presence of both simple and complex febrile seizures have also been documented in sudden unexpected death in childhood cohorts, and there may be similarities in the underlying pathophysiology to sudden unexpected death in epilepsy. Finally, in some cases the presence of complex febrile seizures may herald the onset of a devastating developmental and epileptic encephalopathy (i.e., Dravet syndrome) or Febrile-Infection Related Epilepsy Syndrome (FIRES). In this narrative review the authors explore the current state of management of complex febrile seizures, their neurological sequelae and morbidity as well as rare epilepsy syndromes and conditions associated with them.

De novo SCN1A missense variant in a patient with Parkinson’s disease

BackgroundVariants in a gene encoding sodium voltage-gated channel alpha subunit 1 (SCN1A) are known to cause a broad clinical spectrum of epilepsy and associated features, including Dravet syndrome (MIM 607208), non-Dravet developmental and epileptic encephalopathy (MIM 619317), familial febrile seizures (MIM 604403), familial hemiplegic migraine (MIM 609634), and generalized epilepsy with febrile seizures (MIM 604403).MethodsIn this study, we examined a patient with Parkinson’s disease (PD) without any clinical manifestations of epilepsy and associated features. Genomic nucleic acid was extracted, and a complete coding sequence of the human genome (whole-exome sequencing) was sequenced. Moreover, Sanger sequencing of variants of interest was performed to validate the exome-discovered variants.ResultsWe identified a heterozygous pathogenic missense mutation (c.1498C>T; p.Arg500Trp) in the SCN1A gene in the patient using the whole-exome sequencing approach. The onset of PD features in our patient occurred at the age of 30 years. Biochemical investigations were carried out to rule out any secondary cause of the disease, including Wilson's disease or another metabolic disorder. MRI of the brain and spinal images were unremarkable. Moreover, a dramatic response to carbidopa–levodopa treatment was also observed in the patient.ConclusionOur results suggest that the pathogenic variant in SCN1A may lead to PD features without epilepsy.

Two Novel Variants in the CHRNA2 and SCN2A Genes in Italian Patients with Febrile Seizures

Background: Febrile seizures (FSs) are the most common form of epilepsy in children aged between six months and five years. The exact cause is unknown, but several studies have demonstrated the importance of genetic predisposition, with increasing involvement of receptors and ion channels. The present study aims to identify novel pathogenic variants in Italian patients with FSs. Methods: We performed targeted panel sequencing in a cohort of 21 patients with FSs. In silico analysis was performed to predict the pathogenic role of the resulting variants. Results: We found two novel variants segregating in two families with FSs: c.1021C>G (p.Leu341Val) in the CHRNA2 gene and c.140A>G (p.Glu47Gly) in SCN2A. Conclusions: The c.1021C>G (p.Leu341Val) variant leads to a codon change of highly conserved leucine to valine at position 341 and is located in segments M3 of the subunit, which is important for channel gating. The c.140A>G (p.Glu47Gly) variant causes a substitution of glutamic acid with glycine at position 47 of the protein, which is highly conserved across the species. Moreover, it is located in the N-terminal domain, a region commonly affected in ASD, which impacts the inactivation kinetics and voltage dependence of steady-state activation. Further analyses are needed to better explain the role of CHRNA2 and SCN2A in the development of febrile seizures.

A Cross-sectional Study to Describe Utility of Neutrophil-to-lymphocyte Ratio and Combination of C-reactive Protein and Neutrophil-to-lymphocyte Ratio among Children with Febrile Seizure

A Cross-sectional Study to Describe Utility of Neutrophil-to-lymphocyte Ratio and Combination of C-reactive Protein and Neutrophil-to-lymphocyte Ratio among Children with Febrile Seizure

Evaluation of Neutrophil Gelatinase-Associated Lipocalin Levels in Children With Febrile Seizures: A Case-Control Study.

Febrile seizure (FS) is a common pediatric neurological disorder, which may be associated with hypoxia and kidney injury. We aimed to investigate serum levels of neutrophil gelatinase-associated lipocalin (NGAL) in children with FS. This case-control study included 50 children with FS, 50 febrile controls (FCs), and 50 healthy controls (HCs). We measured serum NGAL levels using a human enzyme-linked immunosorbent assay. Serum NGAL/creatinine values showed significant differences within and between study groups with the highest levels for the FS group (1382 ± 215), the middle for FCs (1133 ± 129), and the lowest for HCs (857 ± 97). None of the study participants had abnormal serum creatinine levels, and their values were comparable among the 3 study groups. In conclusion, children with FS may have increased serum NGAL levels despite normal serum creatinine, indicating that FS could contribute to subclinical renal injury without significant loss of excretory kidney function.

Investigating the effect of polygenic background on epilepsy phenotype in ‘monogenic’ families

Phenotypic variability within families with epilepsy is often observed, even when relatives share the same monogenic cause. We aimed to investigate whether common polygenic risk for epilepsy could explain the penetrance and phenotypic expression of rare pathogenic variants in familial epilepsies. We studied 58 clinically heterogeneous families with genetic epilepsy with febrile seizures plus (GEFS+). Relatives were coded as either unaffected or affected with epilepsy, and graded according to phenotype severity: no seizures, febrile seizures (FS) only, febrile seizures plus (FS+), generalised/focal epilepsy, or developmental and epileptic encephalopathy (DEE). Epilepsy polygenic risk scores (PRSs) were tested for association with epilepsy phenotype. Within families, the mean PRS difference was compared between pairs concordant versus discordant for phenotype severity. Statistical analyses were performed using mixed-effect regression models. 304 individuals segregating a known, or presumed, rare variant of large effect, were studied. Within families, higher epilepsy polygenic risk was associated with an epilepsy diagnosis (OR=1.39, 95% CI 1.08, 1.80, padj=0.040). Relatives with a more severe phenotype had a mean pairwise PRS difference of+0.19 higher than relatives with a milder phenotype (padj=0.010). The difference increased with greater phenotype discordance between relatives. As the cohort included two rare variants with >30 relatives each, variant-specific genotype-phenotype associations could also be analysed. Whilst the epilepsy PRS effect was strong for relatives segregating the GABRG2 p.Arg82Gln pathogenic variant (padj=0.0010), the effect was not significant for SCN1B p.Cys121Trp. We provide support for genetic background modifying the penetrance and phenotypic expression of rare variants associated with 'monogenic' epilepsies. In GEFS+families, relatives with higher epilepsy PRSs were more likely to show penetrance (epilepsy diagnosis) and a more severe phenotype. Variant-specific analyses suggest that some rare variants may be more susceptible to PRS modification, carrying important genetic counselling and disease prognostication implications for patients. National Health and Medical Research Council of Australia, Medical Research Future Fund of Australia.

Comparison of serum electrolytes in children with febrile seizures to febrile children without seizures: a case control study

Comparison of serum electrolytes in children with febrile seizures to febrile children without seizures: a case control study

Clinical characteristics of severe influenza as a risk factor for febrile seizures in children: a retrospective analysis.

To retrospectively analyze the clinical characteristics and independent risk factors of severe influenza combined with febrile seizures, and to provide more basis for early clinical intervention. A total of 161 children with severe influenza were collected as study subjects and divided into convulsive (FC) group (40 cases) and non-convulsive (NFC) group (121 cases) according to whether they had febrile seizures. The demographic characteristics and clinical data of the two groups were analyzed. Multivariate logistic regression was used to analyze the risk factors of severe influenza combined with febrile seizures. The predictive efficacy was evaluated by receiver operating characteristic (ROC) curve analysis. (1) Multiple logistic regression analysis revealed that C-reactive protein (CRP) levels, Serum interleukin 6 (IL-6) levels, Days from onset of Flu symptoms to hospitalization, cerebrospinal fluid protein (CSF-TP) levels and the influenza virus type A (FluA) infection rate were found to be independent risk factors for severe influenza combined with febrile seizures in children. (2) ROC curve analysis showed that the cut-off value of CRP, Serum IL-6, Days from onset of Flu symptoms to hospitalization and CSF-TP were 7.57 mg/L, 9.84 pg/ml, 4.5 days and 194.8 mg/L, respectively. Children with severe influenza with CRP ≥ 7.57 mg/L, Serum IL-6 ≥ 9.84 pg/ml, Days from onset of Flu symptoms to hospitalization ≤4.5 days, CSF-TP ≥ 194.8 mg/L and FluA had a significantly increased risk of febrile seizures. It is useful for clinicians to determine the risk of severe influenza combined with febrile seizures, to adjust the early treatment plan, and to reduce the incidence of critically ill patients.

Recessive Variants in PIGG Cause a Motor Neuropathy with Variable Conduction Block, Childhood Tremor, and Febrile Seizures: Expanding the Phenotype.

Biallelic variants in phosphatidylinositol glycan anchor biosynthesis, class G (PIGG) cause hypotonia, intellectual disability, seizures, and cerebellar features. We present 8 patients from 6 families with a childhood-onset motor neuropathy and neurophysiology demonstrating variable motor conduction block and temporal dispersion. All individuals had a childhood onset tremor, 5 of 8 had cerebellar involvement, and 6 of 8 had childhood febrile seizures. All individuals have biallelic PIGG variants, including the previously reported pathogenic variant Trp505*, plus 6 novel variants. Null enzyme activity is demonstrated via PIGO/PIGG double knockout system for Val339Gly and Gly19Glu, and residual activity for Trp505* due to read-through. Emm negative blood group status was confirmed in 1 family. PIGG should be considered in unsolved motor neuropathy. ANN NEUROL 2024.

Identification of Reliable Reference Genes for Use in Gene Expression Studies in Rat Febrile Seizure Model.

The study of the pathogenesis of febrile seizures and their consequences frequently necessitates gene expression analysis. The primary methodology employed for such analysis is reverse transcription with quantitative polymerase chain reaction (RT-qPCR). To ensure the accuracy of data obtained by RT-qPCR, it is crucial to utilize stably expressed reference genes. The objective of this study was to identify the most suitable reference genes for use in the analysis of mRNA production in various brain regions of rats following prolonged neonatal febrile seizures. The expression stability of eight housekeeping genes was evaluated using the online tool RefFinder in the dorsal and ventral hippocampal regions and in the temporal and medial prefrontal cortex of the brain. The Ppia gene exhibited the greatest stability of expression. Conversely, the genes with the least stable expression levels were Actb and Ywhaz; thus, it is not recommended to use them for normalization in a febrile seizure model. Additionally, the majority of housekeeping genes demonstrate age-related, region-specific fluctuations. Therefore, it is crucial to employ the appropriate housekeeping genes for each brain structure under investigation when examining the expression dynamics of genes of interest in a febrile seizure model.

The Knowledge, Concerns, and Beliefs of Mothers Towards Febrile Convulsions and Its Management in Aseer, Saudi Arabia.

Introduction Febrile convulsions are common in children aged six months to five years, causing significant parental distress despite being generally harmless. Various beliefs about their causes exist, including high fever and supernatural factors. Previous studies indicate that mothers' education levels and occupations influence their knowledge and attitudes toward febrile convulsions. This study in Aseer, Saudi Arabia, aimed to assess mothers' knowledge, concerns, and beliefs about febrile convulsions to identify educational needs. Methodology This cross-sectional study was conducted in Aseer, Saudi Arabia, and performed from October 2023 to July 2024. Data were collected via an online questionnaire. The collected data were cleaned in MS Excel (Redmond, WA: Microsoft Corp.) and analyzed in IBM SPSS version 29 (Armonk, NY: IBM Corp.). Results This study surveyed 538 mothers with 25.7% (n=138) aged 36-45 years, and 77.0% (n=414) were married. Regarding the number of children, 25.5% of participants (n=137) had none, 18.6%(n=100) had one child, 14.1% (n=76) had two, and 41.8% (n=225) had three or more children. Education levels showed 56.9% (n=306) had university degrees or higher. Among 401 participants, 30.9% (n=124) reported febrile convulsions in their children. The first convulsion was beforeone year of age in 14.0% (n=56), and between one and five years in 29.2% (n=117) participants. Misconceptions were common, with 73.3% (n=294) mistakenly believing that febrile convulsions are a form of epilepsy. Higher maternal education was significantly associated with lower knowledge about febrile convulsions (p=0.040), and mothers with children who hadexperienced febrile convulsions demonstrated significantly lower knowledge (p=0.003). Conclusion This study provides valuable insights into the knowledge, concerns, and beliefs of mothers in Aseer, Saudi Arabia, regarding febrile convulsions. While there is a high level of awareness about some aspects, significant misconceptions persist. Higher education and children with febrile convulsions are negative predictors of high awareness and knowledge about febrile convulsions.

Evaluation of Febrile Seizures Focusing on the Diurnal Variation.

Background and objectives Several studies have reported the diurnal variation of febrile seizures (FS) in children. However, it remains unclear whether there is a difference in diurnal variation depending on the types of FS. The present study aims to investigate whether simple FS or complex FS influences diurnal fluctuations. Methods In this single-facility retrospective study, Japanese pediatricians collected clinical data from 247 children with FS. We evaluated the diurnal occurrence of FS using medical files. The Kolmogorov-Smirnov test was used to assess differences in distribution by classifying days into four six-hour time periods: night (0:00-6:00), morning (6:00-12:00), afternoon (12:00-18:00), and evening (18:00-24:00). Results In the simple FS group, the highest rate was observed in the evening (35.16%), followed by the afternoon (29.69%), with the lowest rate in the morning (14.06%). In the complex FS group, the highest rates were observed in both the afternoon (30.95%) and evening (30.95%), with the lowest rate at night (16.67%). The distributions of simple FS and complex FS were significantly different. Conclusion FS exhibited different diurnal variations depending on the type of FS. Clinicians' recognition of these findings will aid in treatment.

Development and validation of a nomogram for the estimation of the prognosis of patients presenting with a febrile seizure

BackgroundFebrile seizures constitute a prevalent emergency in early childhood. Previous studies indicated that certain febrile seizures in children may progress to epilepsy, exerting a substantial impact on children's health and developmental trajectory. The objective of this study was to formulate a predictive nomogram to assess the likelihood of transitioning from febrile seizures to epilepsy in pediatric patients, thereby facilitating informed decisions regarding medical interventions for febrile seizures.MethodsA total of 306 patients were enrolled and categorized into training (70%) and test (30%) cohorts. Clinical characteristics were subjected to comparison utilizing chi-squared and t tests. Multivariate logistic regression was employed to identify significant factors for predicting the risk of transitioning from febrile seizures to epilepsy, leading to the development of a nomogram. The nomogram’s performance was assessed through receiver operating characteristic curves, calibration, and decision curve analysis.ResultsPredictive factors associated with the transition to epilepsy encompassed lower Na, elevated RDW, IL-6, and increased background slow rhythm and epileptiform discharges in EEG. The nomogram, incorporating five factors, exhibited commendable predictive value (AUC train = 0.812, AUC test = 0.791) for assessing the risk of transitioning from febrile seizures to epilepsy. Calibration analyses confirmed reliability, and decision curve analysis underscored its clinical utility.ConclusionsLower Na, elevated RDW, IL-6, background slow rhythm, and epileptiform discharges are associated with the risk of transitioning from febrile seizures to epilepsy. The nomogram stands as a valuable tool for predicting this risk, aiding in the strategic implementation of medical interventions to enhance outcomes for patients with febrile seizures.

Developmental and epileptic encephalopathy 56 due to YWHAG variants: 12 new cases and review of the literature

Background and objectivesDevelopmental and epileptic encephalopathy 56 (DEE-56) is caused by pathogenic variants in YWHAG and is characterized by early-onset epilepsy and neurodevelopmental delay. This study reports on a cohort of DEE-56 individuals, correlating antiseizure medication usage and comorbidities, to aid in understanding disease evolution. MethodsWe analyzed data from thirty-nine individuals aged 3–40 years with YWHAG variants, including 12 previously unreported individuals (2 of these with recurrent distal 7q11.23 deletions) and 27 previously published cases (21 families, including 3 adult individuals reported in a family case). Our assessments encompassed clinical, radiological, and genetic evaluations. All procedures adhered to standardized protocols for patient approvals, registrations, and data collection. ResultsIndividuals with YWHAG variants exhibited variable psychomotor delay, with the majority experiencing mild intellectual disability. Early-onset seizures, particularly febrile seizures, were common, with various seizure types reported. Valproic acid has emerged as an effective antiseizure medication. Movement disorders were present in a subset of individuals, primarily manifesting as ataxia and tremor. Comorbidities such as autism spectrum disorders and attention deficit-hyperreactivity disorder were observed in a proportion of individuals. We identified a novel YWHAG variant (c.634_645del/p.Asn212_Ser215del) and expanded the genotypic spectrum of the disease. ConclusionsWe provide insights into the clinical, radiological, and genetic features of YWHAG-related epileptic encephalopathy. Despite mild clinical symptoms, affected individuals face challenges in daily functioning, underscoring the need for comprehensive care. Valproic acid has been used for seizure control with variable results.

Prevalence and Home Management Practice Of Febrile Convulsion Among Children Admitted In a Tertiary Institute Of A Developing Country

Introduction/Objectives Febrile convulsion (FC) is a convulsion triggered by fever of extra-cranial origin in young children between the ages of 3 months and 5 years. The objectives of this study were to determine the prevalence and home management practices of children admitted in the children emergency room (CHER), UCTH, Calabar, Nigeria. Methods/Materials A cross-sectional descriptive study, carried out using quantitative and qualitative methods (admission register and key informant interview). Any child with febrile convulsion admitted into CHER from June 2017 to May 2018 was recruited for the study and his/her caregiver was interviewed on the home practices in the management of FC. Quantitative data was analyzed with SPSS version 22.0 while thematic coding was used for the qualitative data. Results Out of 1,093 total admissions for the periodunder review, 37 had FC giving a prevalence of 3.4% with a M:F ratio of 1.1:1. Malaria was the most common cause in 59.5%. Caregivers treated FC at home by giving the children palm oil, palm kernel oil and crude oil to drink, rubbing olive oil, heating child’s feet on fire and using spoon to keep the mouth open, while some rushed the child to the hospital immediately. Conclusion The prevalence of FC was low and most of the home remedies applied by caregivers were harmful. It is recommended that there is need to intensify health education and create more awareness on the proper management of FC among caregivers in Calabar.

Clinical characteristics and serum 25-hydroxyvitamin D levels in children with febrile seizures in China

The aim of this study was to evaluate the serum level of 25-hydroxyvitamin D (25(OH)D) in children with febrile seizures (FS) in Luzhou, Sichuan Province, China, and in particular its association with gender and age. This should inform possible strategies for supplementation with vitamin D, and hence for prevention of FS in the local pediatric population. The Febrile seizures group consisted of 747 children hospitalized with FS at the Southwest Medical University Affiliated Hospital from January 2020 to January 2024. The healthy control group was comprised of 750 children aged from 0 to 8 years who underwent health checkups during this period. The serum 25(OH)D level was analyzed in relation to gender and age to explore its association with FS. The median serum vitamin D level in the FS group (28.8 ng/mL; IQR 21.64, 33.64) was significantly lower than in the healthy control group (37.51 ng/mL; IQR 31.05, 37.51). The incidence of vitamin D deficiency in the FS group was 10.8%, which was significantly higher than in the healthy control group (P < 0.05). In addition, the serum vitamin D level in children with FS varied in different age groups, with significantly lower levels observed in older children (P < 0.05). ROC curve analysis revealed that a serum vitamin D level of 35.28 ng/mL showed 60.0% sensitivity and 84.7% specificity for predicting FS (P < 0.05). In this study cohort, the serum vitamin D level in children with FS was at the lower limit of the physiological range, and significantly lower than in healthy children. Furthermore, this level decreased with age in children with FS. Regular supplementation with vitamin D for 6 months after birth and outdoor sun exposure for more than 2 h per day can improve the serum vitamin D level in children with FS.

Heterozygous variants in USP25 cause genetic generalized epilepsy.

USP25 encodes ubiquitin-specific protease 25, a key member of the deubiquitinating enzyme family that is involved in neural fate determination. Although abnormal expression in Down's syndrome was reported previously, the specific role of USP25 in human diseases has not been defined. In this study, we performed trio-based whole exome sequencing in a cohort of 319 cases (families) with generalized epilepsy of unknown aetiology. Five heterozygous USP25 variants, including two de novo and three co-segregated variants, were determined in eight individuals affected by generalized seizures and/or febrile seizures from five unrelated families. The frequency of USP25 variants showed a significantly high aggregation in this cohort compared with the East Asian population and all populations in the gnomAD database. The mean age at onset of febrile and afebrile seizures were 10 months (infancy) and 11.8 years (juvenile), respectively. The patients achieved seizure freedom, except that one had occasional nocturnal seizures at the last follow-up. Two patients exhibited intellectual disability. Usp25 was expressed ubiquitously in mouse brain with two peaks, on embryonic Days 14-16 and postnatal Day 21, respectively. In human brain, likewise, USP25 is expressed in the fetus/early childhood stage and with a second peak at ∼12-20 years old, consistent with the seizure onset age in patients during infancy and in juveniles. To investigate the functional impact of USP25 deficiency in vivo, we established Usp25 knockout mice, which showed increased seizure susceptibility compared with wild-type mice in a pentylenetetrazol-induced seizure test. To explore the impact of USP25 variants, we used multiple functional detections. In HEK293 T cells, the variant associated with a severe phenotype (p.Gln889Ter) led to a significant reduction of mRNA and protein expressions but formed stable truncated dimers with an increment of deubiquitinating enzyme activities and abnormal cellular aggregations, indicating a gain-of-function effect. The p.Gln889Ter and p.Leu1045del variants increased neuronal excitability in mouse brain, with a higher firing ability in p.Gln889Ter. These functional impairments align with the severity of the observed phenotypes, suggesting a genotype-phenotype correlation. Hence, a moderate association between USP25 and epilepsy was noted, indicating that USP25 is potentially a predisposing gene for epilepsy. Our results from Usp25 null mice and the patient-derived variants indicated that USP25 would play an epileptogenic role via loss-of-function or gain-of-function effects. The truncated variant p.Gln889Ter would have a profoundly different effect on epilepsy. Together, our results underscore the significance of USP25 heterozygous variants in epilepsy, thereby highlighting the critical role of USP25 in the brain.

Frequency and characteristics of seizures precipitated by febrile urinary tract infections in neonates and infants

BackgroundA febrile urinary tract infection (UTI) is a minor febrile seizure (FS) determinant. Seizures precipitated by febrile UTIs in neonates and infants frequently surprise parents, as they are vulnerable to bacterial meningitis and younger than the usual ages of FS. However, their frequency and characteristics are relatively unknown. MethodsThis study screened 1059 children (≤12 months) with febrile UTIs admitted to Chonnam National University Children's Hospital from January 2015 to June 2023. Patients with seizures precipitated by febrile UTIs were enrolled, and their medical records were reviewed. The frequency and clinical characteristics of seizures effectuated by febrile UTIs were investigated by comparing FS, FS+, and afebrile seizure (aFS). ResultsTwenty-eight patients (2.6%) were enrolled: 19 with early-onset FS+ (2.3% of 814 patients <6 months), nine with FS (3.7% of 245 patients), but there were none with aFS. Acute pyelonephritis was found in 80.8% of 26 patients. Clustered seizures (47.4% vs. 22.2% in FS, P = 0.197) and complex types (73.7% vs. 22.2%; P = 0.015) were frequent in early-onset FS+. Among 42 seizure episodes, bilateral tonic seizures were noted only in FS+ (44.8%; P = 0.001), but bilateral tonic-clonic seizures were frequent in FS (69.2% vs. 27.6%; P = 0.011). ConclusionSeizures precipitated by febrile UTIs occurred in 2.6% of neonates and infants: all were febrile and were predominantly with acute pyelonephritis. Infantile FS characteristics of febrile UTIs resembled those of usual FS, whereas early-onset FS + differed significantly as usually occurring in complex types and bilateral tonic ones.