Recurrent Febrile Seizures Research Articles

A study of serum zinc levels in febrile seizures

Febrile seizures are the most common cause of convulsions in children. However, the exact underlying etiology and the pathophysiological mechanisms are yet to be established. Various theories have been put forward regarding the role of trace elements as predisposing factors in causing the convulsions. Among them, Zinc is the most interesting trace element whose role in diarrhea and pneumonia is well proven. Serum Zinc levels has been long associated with the febrile seizures. The main reason is still unknown for febrile seizures. In this prospective study, we evaluated zinc level in children with the first FS attack. Our findings can help clinicians with a fair idea of serum zinc levels about the use of zinc supplements for preventing the recurrence of febrile seizures via regulation of some neurological functions.

Iron deficiency anemia as a risk factor for simple febrile seizures in pediatric patients

Background: Febrile seizure (FS) is the most common cause of seizure in children, occurring between 6-60 months. It coincides with peak age of incidence for Iron deficiency anemia (IDA). Iron is required for optimal growth and development and its deficiency is associated with numerous problems including persistent cognitive and motor delays. The objective was to study the role of IDA as a risk factor for simple febrile seizure and its recurrenceMethods: A case control study was conducted among 90 febrile children - 45 cases with simple febrile seizure and 45 cases with febrile illness, between the age group of six months to five years of age at Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, between September 2013 and June 2015. The hematological parameters like Hemoglobin, Serum ferritin and RDW were compared between the two groups with respect to fever and different temperature intervals, recurrence of FS.Results: Hb and Serum Ferritin levels were found to be significantly associated with simple febrile seizure, with p value of <0.002 and 0.001 respectively. Similar association was found at different temperature intervals. However, there was no association of hematological parameters with FS recurrence.Conclusions: IDA is a significant risk factor for FS in children while same may not have any effect on the recurrence of FS.

Dravet Syndrome: Early Diagnosis and Emerging Therapies

AbstractDravet's syndrome (DS) or severe myoclonic epilepsy of infancy is a rare, genetic, and infantile-onset epileptic encephalopathy. DS presents with recurrent febrile seizures and/or febrile status epilepticus in developmentally normal infants, and subsequently evolves into a drug-resistant mixed-seizure disorder with developmental arrest or regression. As many defining clinical features of DS do not become evident until 3 to 4 years of age, diagnosis is often delayed. Early seizure control, particularly the prevention of status epilepticus in infancy, has been shown to correlate with better long-term outcomes. Thus, early diagnosis and seizure control is crucial. Several treatment algorithms have been published in recent years to guide antiepileptic drug selection and escalation. Last year, two agents, stiripentol and cannabidiol, were approved by the U.S. Food and Drug Administration specifically for use in DS, and a third has been submitted (fenfluramine). Additional therapies, including serotonin modulators lorcaserin and trazodone, verapamil, and several first-in-class medications, are currently in various phases of investigation.

P09-T An extraordinary EEG phenomenon misdiagnosed as nonconvulsive status epilepticus: Subclinical ictal discharges interrupted by verbal stimuli

Background Triggering or modulation of seizures and rhythmic EEG patterns by external stimuli are well-known but an exclusive stopping effect by sound was not reported before. Here, we report a peculiar manifestation of stimulus-related ictal discharges, namely, subclinical ictal discharges interrupted by sudden verbal stimuli. Case The patient is a 20-year-old woman with recurrent febrile seizure history between the age of 4 months to one year and marked psychomotor developmental delay of unknown cause. She also had brief episodes of staring and sometimes bilateral tonic-clonic seizures. Neurological examination revealed strabismus and microcephaly. Brain MRI did not show any abnormality. At age of 8 years, self-mutilating and agitated behaviors were noted. First EEGs revealed bifrontal 2.5–3.5 Hz spike and waves with impaired background activity. Video-EEG showed frequent patterns of long-lasting (10–60 s) bilateral paroxysmal high-voltage slow waves with occasional spikes, misdiagnosed as non-convulsive status epilepticus. However, no apparent clinical change was noted by the technician, physician and mother during these subclinical ictal EEG recordings. Interestingly, these epileptic discharges were abruptly interrupted with sudden verbal stimuli. Lysosomal enzyme activities and metabolic screening tests were unremarkable. Molecular genetic investigations for ring 20 chromosome analysis and SLC2A1 gene analysis were also unremarkable. Her seizures were partly controlled with levetiracetam, valproic acid and primidone. Conclusion We report the “reverse” type of stimulus-induced, rhythmic, periodic or ictal discharges (SIRPIDS), that is stopped by the external sound in a patient with developmental delay. External modulation of ictal-appearing EEG patterns may show clues for hidden mechanisms of epileptogenesis.

Association of vitamin D levels with simple febrile seizures in under five children: a case control study

Background: There is increasing concern that vitamin D deficiency may play etiological role in Febrile seizures. Few studies have reported vitamin D deficiency in children with recurrent febrile seizures and hypocalcemia seizures. The objective of this study is to explore vitamin D status in children aged 6 months to 5 years with first episode of febrile seizure and to find the association between vitamin D levels and febrile seizure.Methods: A hospital-based case control study was conducted in sub district hospital, Katra over a period of three years. Cases were children of age group 6 months to 5 years presenting with first episode of simple febrile seizure to the casualty or OPD. For each case, a control was selected with similar age group and same sex who came for short duration fever (<2 days) but without seizures. A 5ml of blood sample for measurement of 25 hydroxy vitamin D was taken from the peripheral vein of each participant by trained laboratory technician. In order to categorise various degrees of vitamin D deficiency, Indian Academy of paediatrics criteria was used. Results were presented in the form of percentages and Odds ratio was calculated as measure of association.Results: A total of 75 cases and 75 controls were included in the study. Cases and controls were comparable as per baseline characteristics. Strong and significant (p<0.01) association of febrile seizures with vit D levels was observed.Conclusions: There was a high prevalence of vitamin D insufficiency among cases of simple febrile seizure.

Intermittent clobazam prophylaxis in simple febrile convulsions: a randomised controlled trial

Background: Febrile seizure (FS) is the most common type of childhood seizure disorder with a prevalence of 2-5% in children less than 5 years. Although the prognosis of febrile seizure is usually good, however, the possibility of recurrence keeps many parents and families in a state of anxiety and concerned, for years after the first seizure. Thus, intermittent prophylactic treatment might be advised in children with high risk of recurrence.Methods: The study was a prospective randomized, double blind, placebo-controlled trial conducted at Department of Pediatrics, Umaid Hospital, Dr S N Medical College, Jodhpur on neurologically normal children aged from 6 months to 5 years with a history of simple febrile seizures and normal electroencephalogram without any evidence of acute central nervous system infection. Subjects were randomly prescribed oral clobazam according to weight of child and placebo when they developed a febrile disease during the first 48 h of the onset of fever. Temperature reduction measures with paracetamol and tepid sponging were also advised. Patients were followed up for the frequency and time of febrile seizure recurrence, febrile episodes and side effects of drugs for 12 months.Results: Ten (3.8%) of 257 episodes in clobazam group and 38 (14.07%) episodes in placebo group had seizure recurrence (p value <0.001). The two groups were not significantly different in terms of side effects. (p >0.05).Conclusions: Intermittent oral clobazam therapy is a very effective measure in preventing recurrence of febrile seizures.

Comparison Between Efficacy of Melatonin and Diazepam for Prevention of Recurrent Simple Febrile Seizures: A Randomized Clinical Trial

ObjectivesWe evaluated the efficacy and safety of oral melatonin compared with oral diazepam for prevention of recurrent simple febrile seizures. MethodsThis prospective randomized clinical trial included 60 children aged six to 50 months with recurrent simple febrile seizures who attended the pediatric neurology clinic in Tanta University Hospital. Children were randomly allocated into two groups: the first group (30 children) received oral melatonin 0.3 mg/kg/8 hours, whereas the other group (30 children) received oral diazepam 1 mg/kg/day divided into three doses. Both melatonin and diazepam were given only during the febrile illness, started at the onset of the fever for 48 to 72 hours. Patients were followed up for six months. The primary outcome was recurrence of febrile seizures and the secondary outcome was occurrence of adverse effect related to melatonin or diazepam. ResultsThe recurrence rate of febrile seizures was 17% (5/30) in the melatonin group and 37% (11/30) in the diazepam group. There was no significant difference between the two groups (P = 0.08) (95% confidence interval −0.025 to 0.42). Both melatonin and diazepam have significantly reduced recurrence of febrile seizures (P < 0.001). Adverse effects were reported in 13.3% and 23.3% of the children taking melatonin and diazepam, respectively. No serious side effects were reported with melatonin use. Sedation and dizziness were the main side effects reported in children receiving oral diazepam. ConclusionsOur data suggest that melatonin, administered at the onset of a febrile illness, may effectively reduce the likelihood of recurrent simple febrile seizures. No serious side effects were encountered.

TINGKAT PENGETAHUAN IBU TENTANG KEJANG DEMAM PADA ANAK USIA 6 BULAN SAMPAI 5 TAHUN DI PUSKESMAS KAMPAR TIMUR 2018

Febrile seizures is a disease that is quite common in infants. Half of the occurrence of febrile seizures occur recurrent febrile seizures, this occurs because the child's brain development is still not optimal enough in doing self-defense against the fever, resulting in the rise of febrile seizures. Parents often panic facing the event of febrile seizures. handling fever in children is very dependent on the parents. Level of knowledge of each different mother will lead to the management of fever in different children. This study aims to determine the level of knowledge of the mother about febrile seizures in children aged 6 mounth to 5 years in Puskesmas Kampar East Kampar District in 2018. this research use accidental sampling sampling technique and data collection is done by questioner. The research was conducted on 30 May - 9 June 2018 at Puskesmas Kampar East Kampar District. Sample was 50 respondents with univariate data analysis. The results of this study indicate that the mother's knowledge level is less with the number of 36 people (72%). It is hoped for the Puskesmas to be able to make extantion program about things related to febrile definition dan febrile seizures. And for the mother around Puskesmas Kampar East Kampar District is expected to be more open to new information and more accepting suggestion from nurse and medical officer that exist, especially about information that is important and useful for family health.&#x0D; Key Word : Level knowledge of mother, Febrile seizures

Risk Factors of Recurrence of Febrile Seizures in Children in a Tertiary Care Hospital in Kanpur: A One Year Follow Up Study.

Background:Febrile seizures are commonly seen in children and about one-third of the children develop a recurrence of febrile seizures.Objectives:The main objective is to study the risk factors associated with recurrence of febrile seizures in Indian children.Methods:This prospective, longitudinal study was carried out in the Department of Pediatrics, GSVM Medical College, Kanpur. All children, 6 months to 5 years of age, attending the department from February 2015 to January 2016 presenting with first febrile seizures were included in the study and followed up for recurrence.Results:Of 528 children, 174 (32.9%) had recurrence and 354 (67.1%) had a single episode of febrile seizures. Recurrence was more in children <18 months (41.3%) as compared to children ≥18 months (24.1%). Children with temperature 101°F during the seizure had a recurrence rate of 52.5% while recurrence was seen in only 17.2% in children with temperature ≥105°F. There was a significant declining trend of recurrence with increase in temperature. Recurrence was significantly more common in children with a family history of febrile seizures (45.5%) as compared to those without family history (27.8%). Multiple logistic regression analysis revealed that younger age at onset of first seizure, lower temperature during the seizure, brief duration between the onset of fever and the initial seizure, and family history of febrile seizures were risk factors significantly associated with recurrence of febrile seizures in children.Conclusion:Younger age at first seizure, short duration of fever before the onset of first febrile seizure, lower temperature at onset, and family history of febrile seizures are risk factors of recurrence of febrile seizures in children.

A Review on effectiveness of different Antiepileptic Drugs in Pediatric Febrile Szeizures

Febrile convulsions (FCs) are defined as seizures that occur in children between 6 months and 5 years of age, associated with fever but without intracranial infection or defined causes. The risk of developing epilepsy from a simple FC is 1.0–2.4%, and from a complex FC is 4.1–6.0%. The aim of the study was to assess the effectiveness of antiepileptic drugs in pediatric seizures. The data bases searched are pub med, trip database, science direct and Cochrane library The Type of study is observational studies and randomized control trails. In this study considerable Study population are Infant (1 month) to 6 yrs children. Intervention related to effective treatment of antiepileptic drugs in pediatrics. Patients with only febrile seizures and there treatment are included. Interventional studies are excluded. Children above 6 yrs age and adults are excluded. Patients other than febrile seizures are also excluded. In continuous anticonvulsant therapy, Phenobarbitone is most effective in prevalence of reoccurrence of febrile seizures, Valproic acid is least effective, Carbamazepine and phenytoin does not show any effective. In intermittent anticonvulsant therapy Diazepam is most effective. The effective dugs of antiepileptic drugs in pediatric seizures, Benzodiazepines given intravenously, liquid Diazepam is a safe, effective, and rational alternative. Phenobarbital is effective in recurrence of simple febrile seizures.

Oral Diazepam in Febrile Seizures Following Acellular Pertussis Vaccination

Background:Febrile seizure is the most common type of seizures among children, which is a terrible and frightening experience for parents who are concerned about its recurrence. The aim of this study was to evaluate the effect of diazepam on preventing the recurrence of febrile seizure following acellular pertussis vaccination.Materials and Methods:In this clinical trial, 121 children with a history of febrile seizure that required the pertussis vaccination were enrolled and divided into two groups; the first group was treated with oral diazepam for 48 h after vaccine injection and the control group received antipyretics only if fever occurred after the vaccination and used rectal diazepam for controlling seizure if a seizure occurred. The incidence of fever and seizure after the injection of the vaccine and incidence of febrile seizure were compared.Results:Nearly, 85.7% in the oral diazepam group and 87.9% in the rectal diazepam group had fever after receiving the pertussis vaccine, but the incidence of fever was not significantly different between the groups. Seven children (12.06%) in the rectal diazepam group had a seizure after pertussis vaccination, and none of the children in the oral diazepam group had a seizure after receiving the vaccine at 18 months of age. This difference was significant.Conclusion:Prophylaxis with diazepam administration in children with a history of febrile seizure can prevent recurrence of febrile seizure after pertussis vaccination.

Health Education based on 10 Steps at Mother Knowledge Level in Handling Febrile Seizure on Toddler

Febrile seizure rate on toddler was quite high and tended to increase every year. This was because as toddler experiencing febrile seizures they were not properly handled by the parents. Febrile seizure in toddler if not treated quickly can affect the increasing in seizure frequency and can cause death. The capability of mother in handling febrile seizure must be based on the right knowledge of febrile seizure. The purpose of this study was to determine the level of knowledge of the mother before and after health education based on 10 steps in handling febrile seizure on toddler in Bandar Lampung Adventist Hospital. Experimental research method with one group pretest-posttest designed with random sampling technique approach involving 80 mothers with 0 to 5 year old who had fever being hospitalized. The researchers prepared 10 images of steps in handling febrile seizures randomly and asked the respondents to arrange the pictures according to their knowledge. The results were observed to determine their knowledge rearranging as pretest data. Afterward, health education was given about 10 correct steps. Thereafter, reobserved was made and the knowledge in arranging 10 images was obtained as post test data. The knowledge score before health education was 20.75% and after was 83.75%. While the analytical test used paired t test. The results showed a significant relationship between knowledge before and after health education. p value = 0.00 &lt; 0.05. The results showed that the value of tcount (14.26) &gt; t table (2.26). Increased knowledge in mothers reduced the risk of recurrence of febrile seizures in toddler and the nurse who had not tought these steps needed to run regularly to the mothers whose child was being hospitalized.

Acetaminophen and Febrile Seizure Recurrences During the Same Fever Episode.

To confirm the safety of using acetaminophen for febrile seizures (FSs) and to assess its efficacy in preventing FS recurrence during the same fever episode. In this single-center, prospective, open, randomized controlled study, we included children and infants (age range: 6-60 months) with FSs who visited our hospital between May 1, 2015, and April 30, 2017. The effectiveness of acetaminophen was examined by comparing the recurrence rates of patients in whom rectal acetaminophen (10 mg/kg) was administered every 6 hours until 24 hours after the first convulsion (if the fever remained >38.0°C) to the rates of patients in whom no antipyretics were administered. No placebo was administered to controls. The primary outcome measure was FS recurrence during the same fever episode. We evaluated 423 patients; of these, 219 were in the rectal acetaminophen group, and 204 were in the no antipyretics group. In the univariate analysis, the FS recurrence rate was significantly lower in the rectal acetaminophen group (9.1%) than in the no antipyretics group (23.5%; P < .001). Among the variables in the final multiple logistic regression analysis, rectal acetaminophen use was the largest contributor to the prevention of FS recurrence during the same fever episode (odds ratio: 5.6; 95% confidence interval: 2.3-13.3). Acetaminophen is a safe antipyretic against FSs and has the potential to prevent FS recurrence during the same fever episode.

Evaluation of Febrile Seizures in NGMC And Assessment of Risk Factors For Recurrences

Background: Febrile seizures (FS) are commonly confronted pediatric emergencies in the age group of 6 months to five years. Recurrences of febrile seizures are common. The objective of this study was to evaluate febrile seizures and identification of risk factors for recurrence of febrile seizures in children.Methods: This is a prospective hospital based study conducted in the Department of Pediatrics at Nepalgunj Medical College from July 2015 to June 2016, between age group of 6 months to 5 years meeting inclusion criteria. A complete history, detailed neurological examination and necessary investigations were done. Statistical analysis was computed using Statistical Package for the Social Sciences (SPSS) 16 version.Results: A total number of 72 children with febrile seizure were included in the study. Among them 49 (68%) were males and 23 (32%) were females. Maximum cases i.e. 43(60%) were in the age group of 7 months to 2 years and p value was 0.02 followed by 20(27%) in the age group of 2 years to 3.5 years and minimum were in the age group of 3.5-5 years i. e 9(13%). Simple febrile seizure was seen in 45(63%) and complex febrile seizures was seen in 27(37%). Recurrence of seizure was present in 13(18%) patients. Most common precipitating factor for febrile seizure was upper respiratory tract infection seen in 51(71%) followed by lower tract respiratory infection in 8(11%), acute gastroenteritis in 5(7%) and others 8(11%). Generalized tonic clonic seizures (GTCS) were most common present in 56(78%) patients.Conclusions: Febrile seizures are common amongst male children. Risk of febrile seizures decreases with age. One fourth of children with febrile seizures are at risk for recurrence. Generalized tonic clonic seizures are found to be predominant type of febrile seizures. Most common risk factor for febrile seizure was upper respiratory tract infections (URTI). JNGMC, Vol. 14 No. 2 December 2016, Page: 30-33

PND4 - CLOBAZAM AS INTERMITENT PROPHYLAXIS IN TYPICAL FEBRILE SEIZURES AND THEIR ANEMIC STATUS

To observe incidence of febrile seizures in Pediatric department from October to March 2018. To assess the cause of fever and identify risk factors in subjects with febrile seizures To assess the anemic status in the subjects and history of worm infestations and evaluating the reason for being anemic by using Kuppuswamy scale. To determine the adverse effects with clobazam. To assess the medication adherence status and improving the anemic status of subjects with febrile seizures by providing patient counselling. A descriptive cross-sectional observational study conducted in Government General Hospital, Guntur, a 1187 bedded tertiary care teaching hospital. Patients were randomly assigned to receive oral clobazam for 3 days with the following dosage: 5mg daily in children <5kg; 5mg, twice daily(BD) in children 6-10 kg; 7.5mg BD in children 11-15 kg ; 10mg BD in children >15kg. During the study period, incidence of febrile seizures in pediatric ward GGH was n=188 (5.38%) out of n=3495 children admitted and it was more in the month of December n=30 (6.50%).The mean Haemoglobin value before patient couselling was 7.98±1.35 gms and after counselling was 8.53±1.25 gms with a p value (0.001). The mean value of medication adherance before patient counselling was 3.78±1.61 and after counselling was 5.42±1.50 with a p value (0.001).The major risk factors observed were family history and anemia with a p value of (0.003).There was no recurrence of seizures in 114 subjects after Clobazam therapy as intermittent prophylaxis. The most commonly observed side effect was Sedation n=26 (21.12%) . This study concluded that Clobazam was effective as intermittent prophylaxis in preventing the recurrence of febrile seizures where anemia was a major risk factor and counselling plays a significant role in improving the anaemic status and adherence of the subjects.

Republication de : Évaluation d’un enfant après une crise fébrile : focus sur trois problèmes de pratique clinique

Febrile seizures (FS) are the most common seizures seen in the paediatric population in the out-of-hospital and emergency department settings, and they account for the majority of seizures seen in children younger than 5 years old. An FS is a seizure accompanied by fever, without central nervous system infection, occurring in children between 6 months and 5 years old. Five criteria have been used and taught to classify any FS as simple or complex FS. These factors do not bear the same significance for clinical practice, in particular, the decision to perform a lumbar puncture for cerebrospinal fluid analysis to rule out an intracranial infection. Moreover, epidemiological studies have illustrated that some factors are predictive of febrile seizure recurrence while others are predictive of epilepsy occurrence. On this basis, a workshop was organized to provide an answer to three clinical practice questions: when should a lumbar puncture be performed in a child who has experienced a seizure during a fever episode, is the prescription of a rescue drug required with a risk of a prolonged febrile seizure recurrence, when should a neurological consultation be requested (risk of later epilepsy)? Based on a review of the literature and on a 1-day workshop, we report here the conclusion of the working group. A lumbar puncture is required in any child with meningitis symptoms or septic signs or behaviour disturbance. A lumbar puncture should be discussed based on the clinical symptoms and their progression over time when a child has experienced a focal FS or repetitive FSs without signs of meningitis or sepsis or behaviour disturbance. The lumbar puncture is not necessary in case of simple FS without signs of meningitis, including in infants between 6 and 12 months old. An early clinical evaluation (at least 4 h after the first clinical assessment) could be helpful, in particular in infants younger than 12 months of age. A rescue drug might be prescribed when there is a high risk of prolonged FS (i.e., risk higher than 20 %): age at FS<12months OR a history of a previous febrile status epilepticus OR if the first FS was a focal seizure OR abnormal development/neurological exam/MRI OR a family history of nonfebrile seizure. A neurological consultation should be requested for any child who has experienced a prolonged FS before the age of 1 year, for children who have experienced prolonged and focal FS or repetitive (within 24h) focal FS, for children who have experienced multiple complex (focal or prolonged or repetitive) FS, for children with an abnormal neurological exam or abnormal development experiencing a FS. Although childhood febrile seizures in most cases are benign, witnessing such seizures is always a terrifying experience for the child's parents. Most parents feel that their child is dying or could have severe brain injury related to the episode. Therefore, the group also suggests a post-FS visit with the primary care physician.

Trend of subsequent epilepsy in children with recurrent febrile seizures: A retrospective matched cohort study

PurposeTrends of epilepsy in children were correlated with febrile seizure (FS) in a previous retrospective study. In the present study, the authors obtained relevant data from a nationwide cohort database to investigate trends in subsequent epilepsy in children with a history of recurrent FS. MethodsA total of 10,210 children with FS comprised the cohort. The diagnosis date was used as the index date. A comparison cohort was randomly matched with each case based on age, sex, urbanization level, parents’ occupation, and index date. Cox proportional hazard regression was performed to estimate the hazard ratio and confidence interval of FS-associated epilepsy. ResultsThis retrospective cohort study included 7729 children with FS and a comparison cohort of 30,916 children. The incidence of epilepsy was 11.4-fold higher in the FS cohort than in the comparison cohort (5.67 vs. 0.49 per 1000 person-years, respectively). Compared with the comparison cohort, the epilepsy incidence rate ratio increased in children with admissions for FS, from 8.62 at 1 admission to 26.2 at ≥2 admissions (95% CI 6.80–10.9, and 19.78–34.8, respectively; p for trend < 0.0001). ConclusionFS may increase the risk for subsequent epilepsy in children. Recurrent FS increased the cumulative incidence of epilepsy.

Sociodemographic risk factors for febrile seizures: A school-based study from Izmir, Turkey

PurposeDespite the fact that socioeconomic and environmental factors of a population are changing over time, there are few studies focusing on the effects of sociodemographic factors on the prevalence of febrile seizures (FS). This study was designed to find out the prevalence of FS and to investigate the effect of socio-cultural and economic factors on this prevalence among the Turkish school children. MethodsA school-based, cross-sectional study was conducted in first and second-class children. Data were collected through a questionnaire from the parents who agreed to be involved in the study. The survey had questions about some socioeconomic and demographic features of the children and febrile seizure episodes. Results3806 children and parent pairs accepted to participate in the survey. Febrile seizure prevalence was 4.8%. It was found that the prevalence of FS was significantly associated with the chronic illnesses of a child that requires continuous medication, developmental delay of a child, NICU history, gestational hypertension history of a mother, and lower educational level of a mother. Recurrence of FS was observed in 32.9% of children. Children whose first FS was seen below the 39 °C had 1.9 times more recurrence risk. ConclusionFS prevalence rate has declined from 9.7% to 4.3% in our study population within ten years. It was thought that advancing healthcare systems in our country might be decreased the prevalence. Our study enabled us to find out sociodemographic risk factors of FS, but further studies are needed in order to confirm the effect of sociodemographic factors on FS prevalence.

Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures

The predictive value of epileptiform discharges for subsequent epilepsy after febrile seizures was studied in 140 children: 72 children (51%) had simple febrile seizures and 68 children (49%) had complex febrile seizures. Electroencephalography (EEG) was performed in 103 children (74%), it was normal in 66 (47%) and with epileptiform patterns in 37 patients (26%). At follow-up in 2017, 10 children developed epilepsy, 1 had a single epileptic seizure, 9 of them had epileptiform EEGs. Of the patients with normal EEGs after complex febrile seizures, none developed epilepsy, and 92% of patients with normal EEGs after recurrent febrile seizures did not develop epilepsy. Therefore, patients with normal EEGs were unlikely to develop epilepsy. Fifteen percent of patients with complex and 31% of patients with recurrent febrile seizures and epileptiform EEGs developed epileptic seizures. The positive predictive value of epileptiform discharges was low in complex and twice as high in recurrent febrile seizures.

Febrile seizures: an overview.

BackgroundFebrile seizures are the most common neurologic disorder in childhood. Physicians should be familiar with the proper evaluation and management of this common condition.ObjectiveTo provide an update on the current understanding, evaluation, and management of febrile seizures.MethodsA PubMed search was completed in Clinical Queries using the key terms ‘febrile convulsions’ and ‘febrile seizures’. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews.ResultsFebrile seizures, with a peak incidence between 12 and 18 months of age, likely result from a vulnerability of the developing central nervous system to the effects of fever, in combination with an underlying genetic predisposition and environmental factors. The majority of febrile seizures occur within 24 hours of the onset of the fever. Febrile seizures can be simple or complex. Clinical judgment based on variable presentations must direct the diagnostic studies which are usually not necessary in the majority of cases. A lumbar puncture should be considered in children younger than 12 months of age or with suspected meningitis. Children with complex febrile seizures are at risk of subsequent epilepsy. Approximately 30–40% of children with a febrile seizure will have a recurrence during early childhood. The prognosis is favorable as the condition is usually benign and self-limiting. Intervention to stop the seizure often is unnecessary.ConclusionContinuous preventative antiepileptic therapy for the prevention of recurrent febrile seizures is not recommended. The use of intermittent anticonvulsant therapy is not routinely indicated. Antipyretics have no role in the prevention of febrile seizures.