Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2016 Jul;57(7):1042-7.
doi: 10.1111/epi.13418. Epub 2016 Jun 6.

Risk factors for subsequent febrile seizures in the FEBSTAT study

Dale C Hesdorffer  1 , Shlomo Shinnar  2 , Daniel N Lax  2 , John M Pellock  3 , Douglas R Nordli Jr  4 , Syndi Seinfeld  3 , William Gallentine  5 , L Matthew Frank  6 , Darrell V Lewis  5 , Ruth C Shinnar  2 , Jacqueline A Bello  7 , Stephen Chan  8 , Leon G Epstein  4 , Solomon L Moshé  2 , Binyi Liu  1 , Shumei Sun  9 ; FEBSTAT study team
Collaborators, Affiliations
Multicenter Study

Risk factors for subsequent febrile seizures in the FEBSTAT study

Dale C Hesdorffer et al. Epilepsia. 2016 Jul.

Abstract

Objectives: To identify risk and risk factors for developing a subsequent febrile seizure (FS) in children with a first febrile status epilepticus (FSE) compared to a first simple febrile seizure (SFS). To identify home use of rescue medications for subsequent FS.

Methods: Cases included a first FS that was FSE drawn from FEBSTAT and Columbia cohorts. Controls were a first SFS. Cases and controls were classified according to established FEBSTAT protocols. Cumulative risk for subsequent FS over a 5-year period was compared in FSE versus SFS, and Cox proportional hazards regression was conducted. Separate analysis examined subsequent FS within FSE. The use of rescue medications at home was assessed for subsequent FS.

Results: Risk for a subsequent FSE was significantly increased in FSE versus SFS. Any magnetic resonance imaging (MRI) abnormality increased the risk 3.4-fold (p < 0.05), adjusting for age at first FS and FSE and in analyses restricted to children whose first FS was FSE (any MRI abnormality hazard ratio [HR] 2.9, p < 0.05). The risk for a second FS of any type or of subsequent FS lasting >10 min over the 5-year follow-up did not differ in FSE versus SFS. Rectal diazepam was administered at home to 5 (23.8%) of 21 children with subsequent FS lasting ≥10 min.

Significance: Compared to controls, FSE was associated with an increased risk for subsequent FSE, suggesting the propensity of children with an initial prolonged seizure to experience a prolonged recurrence. Any baseline MRI abnormality increased the recurrence risk when FSE was compared to SFS and when FSE was studied alone. A minority of children with a subsequent FS lasting 10 min or longer were treated with rectal diazepam at home, despite receiving prescriptions after the first FSE. This indicates the need to further improve the education of clinicians and parents in order to prevent subsequent FSE.

Keywords: Febrile seizure recurrence; Simple febrile seizure; Status epilepticus.

PubMed Disclaimer

Conflict of interest statement

Disclosures: The authors report no conflict of interest with respect to this manuscript. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Figures

Figure 1
Figure 1
Risk for a subsequent FSE after a first FS that was FSE compared to a first SFS
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Annegers JF, Blakley SA, Hauser WA, et al. Recurrence of febrile convulsions in a population-based cohort. Epilepsy Res. 1990;5:209–216. - PubMed
    1. Forsgren L, Heijbel J, Nystrom L, et al. A follow-up of an incident case-referent study of febrile convulsions seven years after the onset. Seizure. 1997;6:21–26. - PubMed
    1. Offringa M, Bossuyt PM, Lubsen J, et al. Risk factors for seizure recurrence in children with febrile seizures: a pooled analysis of individual patient data from five studies. J Pediatr. 1994;124:574–584. - PubMed
    1. Berg AT, Shinnar S. Complex febrile seizures. Epilepsia. 1996;37:126–133. - PubMed
    1. Hesdorffer DC, Chan S, Tian H, et al. Are MRI-detected brain abnormalities associated with febrile seizure type? Epilepsia. 2008;49:765–771. - PubMed

Publication types

LinkOut - more resources