Recurrent Febrile Seizures Research Articles

Febrile seizures and behavioural and cognitive outcomes in preschool children: the Generation R Study

General developmental outcome is known to be good in school-aged children who experienced febrile seizures. We examined cognitive and behavioural outcomes in preschool children with febrile seizures, including language and executive functioning outcomes. This work was performed in the Generation R Study, a population-based cohort study in Rotterdam from early fetal life onwards. Information about the occurrence of febrile seizures was collected by questionnaires at the ages of 1, 2, and 3 years. At the age of 3 years, behaviour and emotion were assessed using the Child Behavior Checklist. Information on expressive language development was obtained by the Language Development Survey at the age of 2 years 6 months. To assess executive functioning, parents completed the Behaviour Rating Inventory of Executive Function - Preschool Version when their children were 4 years old. Final analyses were based on 3157 children. No associations were found between febrile seizures and the risk of behavioural problems or executive functioning. In contrast to single febrile seizures, recurrent febrile seizures were significantly associated with an increased risk of delayed vocabulary development (odds ratio 3.22, [95% confidence interval 1.30-7.94]). Febrile seizures are not associated with problem behaviour or executive functioning in preschool children, but the results suggest that children with recurrent febrile seizures might be at risk for delayed language development.

Risk for developing epilepsy and epileptiform discharges on EEG in patients with febrile seizures

Purpose: The aim of the present study was to investigate the correlation between epileptiform discharges on EEGs after febrile seizures and the prognosis of patients in terms of the development of epilepsy and recurrence of febrile seizures. This study also evaluated the characteristics of epileptiform discharges and EEG changes on follow-up examination. Methods: This study consisted of 36 children who presented to our hospital with febrile seizures and whose electroencephalograms (EEG) showed epileptiform discharges. The development of epilepsy and the recurrence of febrile seizures were compared between the study group (n=36) and the control group (n=87), which included children with febrile seizure but with normal EEG findings. Results: No significant correlation was detected between the recurrence rate of febrile seizures in patients with normal EEG (23 out of 87, 26.4%) findings and that of patients whose EEGs showed epileptiform discharges (12 out of 36, 33.3%) [adjusted OR 0.67 (0.26–1.68)]. However, 9 (25.0%) out of 36 patients with epileptiform discharges on EEG had epilepsy compared to 2 patients (2.3%) in the control group. The correlation was statistically significant [crude OR 10.88 (2.47–47.88) and adjusted OR 8.75 (1.49–51.6)]. Conclusion: Epileptiform discharges on the EEGs of patients with febrile seizures are important predictive risk factors of the development of epilepsy.

Mapping an X‐linked locus that influences heat‐induced febrile seizures in mice

Febrile seizures (FS) are the most common seizure type in children between the age of 6 months and 5 years. Although FS are largely benign, recurrent FS are a major risk factor for developing temporal lobe epilepsy (TLE) later in life. The mechanisms underlying FS are largely unknown; however, family and twin studies indicate that FS susceptibility is under complex genetic control. We have recently developed a phenotypic screen to study the genetics of FS susceptibility in mice. Using this screen in a phenotype-driven genetic strategy we analyzed the C57BL/6J-Chr #(A)/NaJ chromosome substitution strain (CSS) panel. In each CSS line one chromosome of the A/J strain is substituted in a genetically homogeneous C57BL/6J background. The analysis of the CSS panel revealed that A/J chromosomes 1, 2, 6, 10, 13, and X carry at least one quantitative trait locus (QTL) for heat-induced FS susceptibility. The fact that many X-linked genes are highly expressed in the brain and have been implicated in human developmental disorders often presenting with seizures (like fragile X mental retardation) prompted us to map the chromosome X QTL. C57BL/6J mice were mated with C57BL/6J-Chr X(A) /NaJ (CSSX) to generate F(2)-generations-CXBL6 and BL6CX-originating from CSSX or C57BL/6J mothers, respectively. Heat-induced FS were elicited on postnatal day 14 by exposure to a controlled warm airstream of 50°C. The latency to heat-induced FS is our phenotype. This phenotype has previously been validated by video-electroencephalography (EEG) monitoring. After phenotyping and genotyping the F(2)-population, QTL analysis was performed using R/QTL software. QTL analysis revealed a significant peak with an LOD-score of 3.25. The 1-LOD confidence interval (149,886,866-158,836,462 bp) comprises 52 protein coding genes, of which 34 are known to be brain expressed. Two of these brain-expressed genes have previously been linked to X-linked epilepsies, namely Cdkl5 and Pdha1. Our results show that the mouse genetics of X-linked FS susceptibility is complex, and that our heat-induced FS-driven genetic approach is a powerful tool for use in unraveling the complexities of this trait in mice. Fine-mapping and functional studies will be required to further identify the X-linked FS susceptibility genes.

The Croatian Society of pediatric neurology guidelines for the diagnosis and therapy of febrile seizures

Febrile seizures are occasional cerebral seizures that occur in 2%-5% of children aged 6-60 months. Despite progress in the understanding of febrile seizures pathophysiology and the development of its guidelines, there are still many variations in the interpretation of these guidelines and in the evaluation and treatment of children with febrile seizures in the Republic of Croatia. Therefore, the Croatian Society of Pediatric Neurology developed the guidelines for the rational diagnosis and therapy of febrile convulsions, which should be feasible in all hospitals in the Republic of Croatia. The purpose of these guidelines is to assist in making rational decisions for diagnosis and treatment and they do not represent the only possible protocol for all patients with this disorder. An additional specific objective is to emphasize the medical evidence based approach to the risk and benefit of continuous and intermittent prophylactic antiepileptic therapy, as well as to the use of antipyretics in children with febrile seizures. Despite the high prevalence and percentage of relapses of febrile seizures, long lasting effects are not known nor scientifically proven in the literature. The risk of developing epilepsy in these patients is low, although slightly higher than in the general population. There is no evidence that the prophylactic use of antiepileptic drugs in children with simple febrile seizures can reduce the incidence of epilepsy. There is no evidence that the use of intermittent diazepam prophylaxis of simple febrile seizures is rational and reasonable. Continuous prophylaxis with antiepileptic drugs or intermittent diazepam therapy may reduce the incidence of recurrent febrile seizures. However, the risk of side effects and potential toxicity of antiepileptic drugs beyond the already low risk of complications in children with simple febrile seizures does not recommend continuous or intermittent therapy with antiepileptic drugs in children with simple febrile seizures. Antipyretics have not been shown to be effective in preventing recurrence of febrile seizures.

Febrile seizures: an epidemiological and outcome study of 482 cases

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. 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. 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. 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.

Duration of recognized fever in febrile seizure predicts later development of epilepsy

The current report examines the risk of and predictors for developing epilepsy in children with febrile seizure (FS). The present study addresses two factors that were previously identified as predictors of recurrent FS in previous reports: maximum temperature and duration of fever prior to the initial FS. Children aged 6 months-6 years with an initial simple FS were eligible for the study. The interview included questions about the child's illness, family history of seizures, and other exposure information. In particular, they were asked about the duration of recognized fever prior to the seizure. After the initial interview, parents were called every 3-4 months to ascertain whether any further seizures had occurred and the circumstances under which such seizures occurred. Follow up ≥ 3 years was attempted for all children. Statistical analysis was done with χ(2) test, Fisher's exact test, Mann-Whitney U-tests and logistic regression analysis. Five of 92 children (5.4%) experienced unprovoked seizures and were considered part of an epilepsy group. In four of these five patients, the duration of recognized fever prior to FS fell more than ± 2.5 SD outside the distribution for the non-epilepsy group. Either an unusually short or long recognized fever prior to the initial FS was associated with an increased risk of unprovoked seizures. The duration of recognized fever appears to provide useful information about the risk for the later development of epilepsy.

Possible Role of Iron Deficiency in Occurrence and Recurrence of Febrile Seizures in Children Aged 6-36 Months

Introduction: Febrile seizures are the most common type of seizures in children. Iron deficiency that affects about 46.5% of Egyptian children. Aim: To investigate the relation of iron status and febrile seizures and its recurrence. Methods: Fifty five children with febrile seizures (group 1) and 55 children with febrile illness with no seizures as control (group2) were included. Both group had no history or clinical examination suggesting neurological abnormalities. Hematological indices HB, MCV, MCH, MCHC and RDW were measured in both groups. Iron status was assessed by serum iron, TIBC, transferrin saturation percentage (TS %) and serum transferrin receptor(s-TFR). Results: Mean age was (19.1±8.7) in group1 and (20±9.4) in group2 (P0.56). Iron deficiency was more prevalent among children with FS (60%) than control group (29.1%) P< 0.01. Children in group1 had significantly lower HB, MCV and MCH than control group. Children with recurrence had significantly lower hemoglobin (9.6±1.7) Vs (10.8±1.3) P < 0.05, serum iron (36.6±4.9 µg/dl) Vs (40.5±4.2 µg/dl) P< 0.05 and serum transferring receptor (s-TFR) (16.4±5.6) mg/l Vs (11.8±2.6 mg/l) P < 0.05 compared to those with no recurrence. There was positive correlation between iron deficiency and recurrence of febrile seizures. There was no relation between type of seizures either focal or generalized socioeconomic state, type of infection and occurrence of febrile seizure. There was no relation between type of seizures either focal or generalized and iron status. Conclusion: Iron deficiency could play a role in occurrence and recurrence of febrile seizures.

Management of Febrile Seizures: Attitudes of Health Care Workers

Background and aim: The strength of evidence-based recommendation on febrile seizures (FS) suggests the opportunity to check the current state of knowledge and behaviour on FS among health care workers (HCW). Methods: We asked to residents in paediatrics (RP), family paediatrician (FP), paediatric consultant (PC) and paediatric nurses (PN) to fill in a questionnaire. From a clinical scenario, the questionnaire asked information about: the incidence of CF in children 6 mos-5 yrs; the probability of another episode; the effectiveness of antipyretics on the prevention of FS; the timing of endorectal diazepam in successive FS; the opportunity to perform an EEG at the first episode. Results: We received 1025 questionnaire (162 PC, 604 FP, 92 RP, 167 PN). Incidence of FS (3-5%) was correctly identified by 64% of the HCW (41% PN, 71% FP); probability of recurrence of FS (20 -30%) by 58% of HCW (47% PN, 64% RP). Seventy-five percent of HCW stated properly that there is no evidence that antipyretics reduce the recurrence. Also 75% of HCW (82% RP, 72% PC) correctly answered that endorectal diazepam should be used if the crisis lasts more than 1-2 minutes. About EEG, 81% correctly reported to not perform it in case of a simple FS (93% RP, 76% PN). Overall, only 45% of HCW provided a correct answer to all five questions formulated. Conclusions: The study shows a reasonable degree of knowledge of HCW, although with a difference between professional groups. Information campaigns and training on the management of FS are needed.

Frequent fever episodes and the risk of febrile seizures: The Generation R Study

Aim To examine the association between the number of fever episodes and the risk of febrile seizures. Methods This study was embedded in a population-based prospective cohort study from early foetal life onwards. Information about the occurrence of febrile seizures and fever episodes was collected by questionnaires at the ages of 12, 24 and 36 months. Analyses were based on 3033 subjects. The risk of febrile seizures was compared between children with frequent fever episodes (>2 per year), and children with only 1 or 2 fever episodes per year. Results The frequency of fever episodes was not associated with the risk of febrile seizures in the age range of 6–12 months. In the second and third year of life, having more than 2 fever episodes was associated with an increased risk of febrile seizures (odds ratios 2.02 [95% confidence interval 1.13–3.62] and 2.29 [95% confidence interval 1.00–5.24], respectively). In the age range between 6 and 36 months, we observed a significant trend between the frequency of fever episodes (<2, 3–4 or >4 per year) and the risk of febrile seizures ( p-value for trend < 0.001). The association between the number of fever episodes and the occurrence of febrile seizures was stronger for children with recurrent febrile seizures. Conclusion Frequent fever episodes are associated with an increased risk of febrile seizures in the second and third years of life. Further studies are needed to identify the mechanisms underlying this association.

Masquerade of a Silent Killer

Masquerade of a Silent Killer

Hyperthermia induces epileptiform discharges in cultured rat cortical neurons

Febrile seizures (FS), or fever-induced seizures, are the most common form of seizures during childhood. Although simple FS are usually considered benign, prolonged or recurrent FS are proposed to increase the risk for developing subsequent temporal lobe epilepsy (TLE) in adults. The pathophysiology of FS is still largely unknown. In this study, by using whole-cell patch-clamp recording techniques, we demonstrated that hyperthermia (39–40 °C) induced a “febrile seizure-like event” expressed as spontaneous, recurrent, epileptiform discharges (SREDs) followed by a series of sustained depolarizations (SDs) in cultured rat cortical neurons (7–14 DIV). The SREDs were characterized by abruptly developing, paroxysmal depolarizing shifts (PDS) of membrane potential with high-frequency spike firing characteristic of electrographic seizures. Furthermore, we also found that hyperthermia induced persistent neuronal hyperexcitability as assessed by their intrinsic electrogenic characteristics which include: 1) depolarized resting potential (RP); 2) decreased input resistance (R in); 3) a marked decrease in amplitude, duration and afterhyperpolarization (AHP) of spontaneous action potentials; 4) a prominent reduction in action potential (AP) current threshold (I th) and potential threshold (TP); and 5) a dramatic shortened duration, decreased inter-spike intervals (ISI), and increased firing frequency of evoked action potentials. Additionally, our present study also revealed that baclofen (100 μM), a specific GABA B receptor agonist, significantly repressed the hyperthermia-induced neuronal hyperexcitability and epileptiform discharges in cultured cortical neurons. The results suggest that hyperthermia may induce epileptiform activities in cultured cortical neurons by suppression of the GABA B receptor-mediated inhibition, in turn leading to the development of persistent neuronal hyperexcitability when the cells suffered from heating insult. This study provides a novel cellular model for studying the pathogenetic mechanisms of febrile seizures in vitro.

Long-term follow-up and outcome of children with febrile seizures

Febrile seizures (FS) precede the onset of various forms of epilepsy in 10%-15% of children. The risk of epilepsy in children with FS is 3% by the age of 7 years. Complex FS are associated with younger age at onset of epilepsy. One-third of patients with temporal lobe epilepsy have a previous history of prolonged febrile seizures. Retrospective data analysis of patients with FS treated at our Neuropediatric Unit and Outpatient Clinic in the last 20 years revealed 880 patients with FS: simple 81.1% and recurrent /complex 18.9%. Thirty-three children had subsequent non-febrile seizures. In 23 children, epilepsy occurred 1-5 years following FS: idiopathic generalized in five, partial idiopathic or cryptogenic extratemporal in seven, temporal in two, and symptomatic partial in three children. After FS, two children had epileptic encephalopathy, two had syndromes with molecular abnormalities, and one child had Fahr disease. One girl who presented for the first time with febrile status epilepticus had Sturge-Weber syndrome. Out of 23 children with epilepsy, 13 had previously had one FS episode and ten recurrent FS. Seven children had good control of epilepsy, while six children had normal intellectual development. Reviewing our 880 patients with FS revealed that 2.6% of them developed epilepsy and two of them had refractory idiopathic temporal lobe epilepsy. There was no case of hippocampal sclerosis in our children with FS and subsequent epilepsy.

The pharmacologic treatment of Dravet syndrome

Dravet syndrome (DS) is one of the most pharmacoresistant epilepsy syndromes. Valproate is used as a first-line agent to prevent the recurrence of febrile seizures and oral/nasal/rectal benzodiazepine is used for any long-lasting seizures, but these agents are most often insufficient. Lamotrigine, carbamazepine, and high doses of intravenous phenobarbital should be avoided because they may worsen seizures. Topiramate, levetiracetam, bromide, and the ketogenic diet may provide substantial efficacy as adjunctive therapy/procedure. Stiripentol is the only compound that proved its efficacy in DS through two independent randomized placebo-controlled trials, when combined with valproate and clobazam. Their dose has to be decreased to minimize the side effects (mostly loss of appetite) resulting from pharmacokinetic interactions of stiripentol powerfully inhibiting cytochromes P450. Stiripentol acts as a γ-aminobutyric acid (GABA)ergic agent, mainly via the α3 subunit of GABA(A) receptors. Stiripentol (Diacomit) was approved as an orphan drug in 2007 in Europe for adjunctive therapy in DS. Up to now, >500 children have been safely treated, and recent experiment in Japan confirmed stiripentol benefit in DS children with comedications other than valproate and clobazam. Because early status epilepticus is likely to negatively impact cognitive outcome, we recommend the introduction of stiripentol as soon as the diagnosis of DS is clinically confirmed. Topiramate and the ketogenic diet are alternatives in pharmacoresistant cases.

La neuropathie héréditaire sensitive et autonome de type IV : à propos de 2 observations

Hereditary sensory and autonomic neuropathy type IV (HSAN IV) is a very rare autosomal recessive disorder characterized by recurrent episodes of unexplained fever, extensive anhidrosis, total insensitivity to pain, hypotonia, and mental retardation. The absence of urticarial reaction to intradermal injection of histamine is a sign of great diagnostic value, but this is common to all types of HSAN. The most frequent complications of this disease are corneal scarring, multiple fractures, joint deformities, osteomyelitis, and disabling self-mutilations. Malignant hyperthermia and sepsis are major causes of mortality. We relate the first observations of two Tunisian children with genetically confirmed HSAN IV. Our goal is to review the clinical aspects of this mysterious neuropathy and to emphasize the peculiarities of its management. These two patients are brothers from 1st-degree consanguineous parents (cousins) with no particular medical history. The 1st patient, the family's 1st child, presented in the 1st h of life with hypotonia and persistent fever, which was refractory to antipyretics. At the age of 8 months, the patient presented recurrent febrile seizures and developed significant self-mutilations of the fingers and tongue. He died 3 months later in a context of multivisceral failure from sepsis and malignant hyperthermia. The 2nd patient, currently aged 4 years, was born after a normal sister. He consulted in the neonatal period for a high fever. The diagnosis of HSAN IV was rapidly suspected and genetically confirmed. In fact, this patient is homozygous for the NTRK1 gene, whereas his sister and both parents are heterozygous. Special predispositions have been taken to improve the course of the disease such as air conditioning to control hyperthermia, a dental tray to reduce the injuries resulting from self-mutilation, regular moistening of the eyes to avoid corneal drying, and chlorpromazine to control hyperactivity and reduce injuries. The good progression with all these predispositions and others underlines the importance of appropriate multidisciplinary management and close monitoring of patients suffering from HSAN IV, especially during the first 3 years of life. Indeed, mortality, behavioral disorders, and mental retardation significantly decrease after this age. New curative treatments are expected in the next decade.

Hydrogen Sulfide: Neurophysiology and Neuropathology

Hydrogen sulfide (H(2)S) was known to be a toxic gas and an environmental hazard for many decades. However, it is now recognized that H(2)S may serve as a gaseous mediator that is endogenously produced to influence biological functions in mammalian. Together with nitric oxide and carbon monoxide, it forms the group of mediators that has been termed the "gasotransmitters." The past decade has seen an exponential growth of scientific interest in the physiological and pathological significance of H(2)S especially with respect to its role in the central nervous system and the cardiovascular system. In the central nervous system, H(2)S facilitates long-term potentiation and regulates intracellular calcium concentration and pH level in brain cells. Intriguingly, H(2)S produces antioxidant, anti-inflammatory, and antiapoptotic effects that may have relevance to neurodegenerative disorders. Abnormal generation and metabolism of H(2)S have been reported in the pathogenesis of ischemic stroke, Alzheimer's disease, Parkinson's disease, and recurrent febrile seizure. Exogenously applied H(2)S is demonstrated to have value for the treatment of febrile seizure and Parkinson's disease. This article presents an overview of current knowledge of H(2)S in relation to brain functions, with a special emphasis on its neuroprotective effects and the underlying cellular and molecular mechanisms.

The art of listening: Bony lesion in a toddler

The art of listening: Bony lesion in a toddler

Evaluation of Iron Status in 9-Month to 5-Year-Old Children with Febrile Seizures: A Case-Control Study in the South West of Iran

Objective Febrile convulsions are prevalent in children aged between 9 months and 5 years, with an incidence of 2-5%. On the other hand, iron deficiency anemia is the most common hematologic disease of infancy and childhood with a period of incidence that coincides with the time of developing febrile convulsions. Therefore, it is hypothesized that there is a possible association between these conditions. This study was designed to elucidate this association. Materials & Methods Two sex and age matched groups (n=50 in each) of 9-month to 5-year-old febrile children who were admitted to Abuzar Hospital between September 2003 and October 2004 were selected. The first group, or the case group, included children with the first attack of febrile seizure and the second group, or the control group, included febrile children without seizure. Blood samples were collected for measuring complete blood count (CBC) indices, serum Iron,ferritin and total iron binding capacity (TIBC) levels. Results Both groups were comparable for age, sex, and the type of febrile illness at admission, except for seizure. There was no significant difference in CBC, Iron and TIBC between two groups but a signicant difference was seen in MCV (Mean Corpuscular Volume), especially in females (P= 0.017). The ferritin level in the case group was significantly lower (30.3 ±16.5 µg/dl) than the control group (84.2 ±28.5 µg /dl) (P= 0.000). Conclusion The findings of this study suggested a positive association between iron deficiency and the first febrile seizure in children. Supplemental iron may prevent the recurrence of febrile seizure. Prudently, further studies with larger sample sizes and longer follow-up periods need to be undertaken to substantiate this hypothesis.

Diazepam Versus Clobazam for Intermittent Prophylaxis of Febrile Seizures

To compare the effectiveness of intermittent clobazam versus diazepam therapy in preventing the recurrence of febrile seizures and assess adverse effects of each drug. This prospective randomized controlled trial was performed 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. The patients were randomly prescribed with oral clobazam (37 cases) or diazepam (35 cases) when they developed a febrile disease. They were advised to use the medications during the first 48 h of the onset of fever. All the patients were monitored regarding developing seizure and adverse effects of the drugs. All patients were followed for 12 months. Overall, 243 episodes of fever occurred during the period, including 116 episodes in the clobazam group and 127 episodes in the diazepam group. Recurrence of seizures occurred in 2 (1.7%) subjects in the clobazam group, and in 4(3.1%) cases in the diazepam group. (P value=0.474). Twenty cases (54%) in the diazepam group and 5 (14.2%) cases in the clobazam group developed drowsiness and sedation during the follow-up period (P value=0.0001). Intermittent clobazam therapy seems advantageous to diazepam due to similar efficacy but significantly lower adverse effects such as drowsiness and sedation.

Ratios of Nine Risk Factors in Children With Recurrent Febrile Seizures

Febrile seizures are the most common convulsive disorder of childhood, with a recurrence probability of 33%. The aim of the study was to determine the risk factors for recurrence of febrile seizures in children. In this descriptive, cross-sectional study, nine risk factors of recurrence of febrile seizures were investigated in 259 children with febrile seizures: (1) sex; (2) domicile; (3) income level; (4) family history of febrile seizures; (5) family history of epilepsy; (6) level of fever; (7) duration of fever; (8) type of seizure, simple vs complex; and (9) age at seizure onset. The risk factors were compared for 119 children with isolated febrile seizures (45.9% of the total) and 140 children with two or more febrile seizure recurrences (54.1%). Among the patients with and without recurrent febrile seizures, 32% and 18% were domiciled in nonurban areas, respectively (P = 0.012). There was a family history of febrile seizures in 57% and 44% of cases with and without recurrent febrile seizures, respectively (P = 0.031). According to the logistic regression analysis, a family history of febrile seizures was a risk factor that affected recurrence (P = 0.018; odds ratio OR = 1.933; 95% confidence interval CI = 1.121-3.333). We also found that domicile (P = 0.001) and income (P = 0.013) were risk factors for recurrence. A family history of epilepsy was not a significant risk factor (P = 0.129; OR = 2.110; 95% CI = 0.804-5.539).

Recurrence of Febrile Seizures in Yazd Shahid Sadoughi Hospital

Objective Febrile seizure is the most common problem in pediatric neurology that occurs in 3- 4 % of children. The purpose of this study was to determine febrile seizure recurrence frequency and to evaluate its risk factors. Materials & Methods In a descriptive prospective study, 139 children (6 months to 6 years) with first febrile seizure were admitted to Yazd Shaheed Sadoughi Hospital between March 2004 and August 2005 and were followed up for at least 15 months for febrile seizure recurrence. Results Seventy six boys and 63 girls with a mean age of 2.03 ± 1.21 years were followed up for 25.1±5.5 months. About 30% of them had complex febrile seizures and 37.4% had febrile seizure recurrence with a mean recurrence time of 6.7 ± 5.9 months. About 65% of the children younger than one year and 30% of those older than one year had febrile seizure recurrence. (P value= 0.0001) Recurrence of seizure was seen in 63% of those who had seizure within an hour from the onset of fever and in 33% of those who had seizure after one hour from the onset of fever. (P value = 0.005) Seizures in children younger than one year old and seizures occurring in association with a fever lasting less than an hour were risk factors of febrile seizure recurrence. Conclusion Febrile seizure is more disturbing in children younger than one year old. Antipyretic usage was not effective in preventing seizure recurrence but may reduce discomfort and is reassuring.