Predictive factors for recurrent febrile seizures in children

  • Pengekuten Marudur Department of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta
  • Elisabeth Herini Department of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta
  • Cahya Dewi Satria Department of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta
Keywords: febrile seizures, recurrence, predictors, prospective

Abstract

Background Oneô€¡third of children who experience febrile seizures
have a recurrence, '\.Vith rates of75% in the first year, and 90% mthin
the second year following the first febrile seizure. Predictive factors
for recurrent febrile seizures have been reported in studies from other
countries, but there have been few of these studies in Indonesia.
Objective To determine predictive factors for the recurrence of
febrile seizures in children.
Methods Children w i t h firstô€¡time febrile seizures were
prospectively followed up, for at least 12 months. Subjects were
recruited consecutively from August 2008 to April 20 1 0 from two
hospitals in Yogyakarta and one hospital in Klaten. We monitored
recurrences of febrile seizure by telephone or home visits to parents
every 3 months. Time to first recurrence of febrile seizures was
analyzed using the Cox regression model.
Results T here were 196 children v,ith firstô€¡time febrile seizures who
completed the follow up. Recurrent seizures were observed in 56
children (28.6%). Me811 follow up time was 21.7 (SD 6.6) months.
Temperature of <40"C at the time of seizure (RR=2.29, 95%CI 135
to 3.89, P=0.OO2), history of febrile seizures in firstô€¡degree relatives
(RR=330, 95%CI 1.25 to 8.08, P<O.OOl), age at first febrile seizure
of <12 months (RRô€¢2.40, 95%CI 1.42 to 4.06, Pô€¢O.OOI) and
duration of fever before the seizure of:51 hour (RR=4.62, 95%CI:
1.35 to 15.80, P=0.015) were significantly associated v,ith recurrence
of febrile seizures. Furthermore, Cox regression analysis revealed
that the age of < 12 months, history of febrile seizures in firstô€¡degree
relatives and temperature of < 40" C were significantpredictive factors
for the recurrence of febrile seizures.
Conclusion Age at first seizure of < 12 months, history of febrile
seizures in firstô€¡degree relatives, and seizure v,ith temperature of
<40"C were independent predictive factors for recurrent febrile
seizures in children. [Paediatr lndones. 2012;52:317,23].

References

1. Ikatan Dokter Anak Indonesia. Konsensus penanganan
kejang demam. Jakarta: Badan penerbit IDAI; 2005: 1-14.
2. Subcommitte on Febrile Seizures American Academy of
Pediatrics. Febrile seizures: clinical practice guideline for
the long􀁈term management of the child v.ith simple febrile
seizures. Pediatr. 2008;12 1:1281-6.
3. Fetveit, A. Assessment of febrile seizures in children. Eur J
Pediatr.2008:167:17-27.
4. Berg AT. Recurrent febrile seizure. In: Baram TZ, Shinnar S,
Editors. Febrile seizures. San Diego: Academic Press; 2002.
p.27-51.
5. Chung B, Wat LCY, Wong V. Febrile Seizures in southern
Chinese children: incidence and recurrence.P ediatr Neurol.
2006;34:121-6.
6. Karande S. Febrile seizures: a review for family phy sicians.
Indian) Med Sci. 2007;61:161-72.
7. Knudsen FU. Recurrence risk after first febrile seizure and
effect of short term diazepam prophylaxis. Arch Dis Child.
1985;60:1045-9.
8. Kjeldsen MJ, Ky vik KO, Friis ML, Christensen K. Genetic and
environmental factors in febrile seizures: a Danish population􀁈
based twin study. Epilepsy Res. 2002;51:167-77.
9. Vestergaard M, Basso 0, Henriksen T B, Ostergaard JR,
Olsen J. Risk factors for febrile convulsions. Epidemiology.
2002;13,282-7.
10. Iwasaki IN, Nakayama J, Hamano K, Matsui A, Arinami
T. Molecular genetics of febrile seizures. Epilepsia. 2002;
43,32-5.
11. Tarkka R. Pathogenesis, prevention of recurrences and
outcome of febrile seizures.[dissertation]. [Oulu]: Oulu
University Press; 2003.
12. Ali W, Bhat MA, Ahmad P, Iqbal J. Basics of convulsive
disorders: febrile seizures.J K Pract.2 006;13:161􀁤3.
13. Berg AT, Shinnar S, Hauser WA, Alemany M, Shapiro ED,
Salomon ME, et al. A prospective study of recurrent febrile
seiwres. N Engl) Med. 1992;327,1122-7.
14. Berg AT, Shinnar S, Darefsky AS, Holford T R, Shapiro ED,
Salomon, ME, et al. Predictors of recurrent febrile seizures:
a prospective cohort study. Arch Pediatr Adolesc Med.
1997; 15 U71-8.
15. Berg AT, Shinnar S, Hauser WA, LeventhalJM . Predictors
of recurrent febrile seizures: a metaanalytic review.J Pediatr.
1990; 116,329-37.
16. Sugai K. Current management of febrile seizures in Japan:
an overview. Brain Dev. 201O;32:64􀁤70.
17. Offringga M, Lubsen OD, Bossuyt PM, Lubsen J. Seizure
recurrence after a first febrile seizure: a multivariate approach.
Brain Dev. 1992;34,15-24.
18. Daoud A.F ebrile convulsion: review and update.J Pediatr
Neuro.2004;2,9-14.
19. Offringa M, Bossuyt PM, Lubsen J, Ellenberg JH, Nelson
KB, Knudsen FU et al. Risk factors for seizure recurrence in
children Mth febrile seizures: a pooled analysis of individual patient data from five studies.J Pediatr. 1994;1 24:574-84.
20. Pavlidou E, T zitiridou M, Kontopoulos E, Panteliadis CPO
W hich factors determine febrile seizure recurrence? A
prospective study. Brain Dev. 2008;30:7-13.
21. Rosman Np, Colton T, Labano ), Gilbert PL, Gardella NB,
Kaye EM et al. A controlled trial of diazepam administered
during febrile illnesses to prevent recurrence of febrile
seiwres. N Engl) Med.1993;329;79-84.
22. Masuko AH, Castro AA, Santos OR, Atallah A, Fernandes
do Prado LD, Carvalho LBC, et al. Intermittent diazepam
and continuous phenobarbital to treat recurrence of febrile
seizures: a systematic review with meta􀁤analysis.A rq Neuro􀁤
Psiquiatr.2003;61,897-90.
23. Rantala H, Tarkka R, Obari MA. A meta􀁤analytic review of
the preventive treatment of recurrences of febrile seizures.J
Pediatr.1997;131,922-5.
24. Autret E, Billard C, Bertrand P, Motte J, Pouplard F, Jonville
AP. Double􀁤blind, randomized trial of diazepam versus
placebo for prevention of recurrence of febrile seizures.J
Pediatr.1990;117;490-4.
25. Tarkka R, Rantala H, Uhari M, Pokka T. Risk of recurrence
after febrile seizure. Pediatr Neurol. 1998;18:218-20.
26. Stuijvenberg M, Lubsen DO, Steyerberg EW, Habbema JDF,
Moll HA. Randomized controlled trial of ibuprofen syrup
administered during febrile illnesses to prevent febrile seizure
recurrences. Pediatrics. 1998; 1 02 :E51.
27. Fukuyama Y, Seki T, Ohtsuka C, Miura H, Hara M. Practical
guidelines for physicians in the management of febrile
seizures. Brain Dev. 1996;18:479-84.
28. Jones T, Jacobsen S]. Childhood febrile seizures: overview
and implications. Int J Med Sci. 2007 ;4: 11OA.
Published
2012-12-31
How to Cite
1.
Marudur P, Herini E, Satria C. Predictive factors for recurrent febrile seizures in children. PI [Internet]. 31Dec.2012 [cited 23Dec.2024];52(6):317-3. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/494
Received 2016-09-08
Accepted 2016-09-08
Published 2012-12-31