Febrile convulsions in a national cohort followed up from birth. II--Medical history and intellectual ability at 5 years of age.

Verity, Christopher; Butler, N; Golding, Jean

doi:10.1136/bmj.290.6478.1311

Cited by 138 publications

(97 citation statements)

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“…Recent epidemiologic studies have confirmed what most pediatricians have thought for decades, that the vast majority of children with febrile seizures have a benign prognosis and a normal long-term outcome (1)(2)(3)(4)(5)(6)(7). There are, however, still unsolved problems.…”

mentioning

confidence: 80%

“…The majority of epilepsies after febrile seizures are generalized, idiopathic epilepsies with tonic-clonic seizures (1)(2)(3)(4)(5)(6)(7). A population-based study from Nova Scotia documented that febrile seizures most often precede epilepsy with tonic-clonic seizures, and prolonged febrile seizures rarely precede idiopathic intractable complex partial seizures (93).…”

Section: Febrile Seizures and Type Of Later Epilepsymentioning

confidence: 99%

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Febrile Seizures: Treatment and Prognosis

Knudsen

2000

Epilepsia

134

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Summary: Recent epidemiologic data indicate that the vast majority of children with febrile seizures have a normal long‐term outcome. A precise knowledge of the short‐ and long‐term outcome with or without treatment, and short‐ and long‐term side effects is an important prerequisite for assessing the various treatment strategies. We focus on the impact of short‐term or prophylactic treatment on the short‐ and long‐term outcome of various types of febrile seizures. There is universal agreement that daily prophylaxis with antiepileptic agents should never be used routinely in simple febrile seizures, but only in highly selected cases, if at all. Intermittent diazepam (DZP) prophylaxis at times of fever may or may not reduce the recurrence rate, but it does not appear to improve the long‐term outcome as compared with short‐term seizure control. The treatment may be used to reduce the recurrence rate for a small arbitrarily defined group with multiple simple febrile seizures, complex febrile seizures, especially focal, prolonged or both, febrile status, and when parental anxiety is severe. However, there is no evidence that treatment of simple febrile seizures can prevent the rare cases of later epilepsy, and many children with complex febrile seizures have a benign long‐term outcome, even without treatment. Many prefer a “wait and see” policy. An attractive alternative is to treat new febrile seizures with rectal DZP in solution at seizure onset, given by the parents at home to prevent febrile status. Newer, less well documented short‐term strategies include nasal, oral, or rectal administration of other benzodiazepines. Short‐term seizure control of febrile status and careful parental counseling are the two most important targets of treatment.

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mentioning

confidence: 80%

Section: Febrile Seizures and Type Of Later Epilepsymentioning

confidence: 99%

Febrile Seizures: Treatment and Prognosis

Knudsen

2000

Epilepsia

134

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“…3 Ellenberg and Nelson 4 studied 431 children who experienced febrile seizures and observed no significant difference in their learning compared with sibling controls. In a similar study by Verity et al, 5 303 children with febrile seizures were compared with control children. No difference in learning was identified, except in those children who had neurologic abnormalities before their first seizure.…”

Section: Introductionmentioning

confidence: 99%

Febrile Seizures: Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures

Seizures¹

2008

Pediatrics

297

121

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Febrile seizures are the most common seizure disorder in childhood, affecting 2% to 5% of children between the ages of 6 and 60 months. Simple febrile seizures are defined as brief (Ͻ15-minute) generalized seizures that occur once during a 24-hour period in a febrile child who does not have an intracranial infection, metabolic disturbance, or history of afebrile seizures. This guideline (a revision of the 1999 American Academy of Pediatrics practice parameter [now termed clinical practice guideline] "The Long-term Treatment of the Child With Simple Febrile Seizures") addresses the risks and benefits of both continuous and intermittent anticonvulsant therapy as well as the use of antipyretics in children with simple febrile seizures. It is designed to assist pediatricians by providing an analytic framework for decisions regarding possible therapeutic interventions in this patient population. It is not intended to replace clinical judgment or to establish a protocol for all patients with this disorder. Rarely will these guidelines be the only approach to this problem. Pediatrics 2008;121:1281-1286The expected outcomes of this practice guideline include:1. optimizing practitioner understanding of the scientific basis for using or avoiding various proposed treatments for children with simple febrile seizures;2. improving the health of children with simple febrile seizures by avoiding therapies with high potential for adverse effects and no demonstrated ability to improve children's long-term outcomes; 3. reducing costs by avoiding therapies that will not demonstrably improve children's long-term outcomes; and 4. helping the practitioner educate caregivers about the low risks associated with simple febrile seizures.The committee determined that with the exception of a high rate of recurrence, no long-term effects of simple febrile seizures have been identified. The risk of developing epilepsy in these patients is extremely low, although slightly higher than that in the general population. No data, however, suggest that prophylactic treatment of children with simple febrile seizures would reduce the risk, because epilepsy likely is the result of genetic predisposition rather than structural damage to the brain caused by recurrent simple febrile seizures. Although antipyretics have been shown to be ineffective in preventing recurrent febrile seizures, there is evidence that continuous anticonvulsant therapy with phenobarbital, primidone, or valproic acid and intermittent therapy with diazepam are effective in reducing febrile-seizure recurrence. The potential toxicities associated with these agents, however, outweigh the relatively minor risks associated with simple febrile seizures. As such, the committee concluded that, on the basis of the risks and benefits of the effective therapies, neither continuous nor intermittent anticonvulsant therapy is recommended for children with 1 or more simple febrile seizures. INTRODUCTIONFebrile seizures are seizures that occur in febrile children between the ages of 6 and 6...

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“…4 The exact pattern of inheritance is uncertain, but many authors favor a multifactorial model. 5,6 Recent studies have identified gene loci associated with febrile seizures on chromosomes 5, 8, and 19. 7-10 Febrile seizures are also strongly age-dependent with the median age of first presentation between 17 and 23 months.…”

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confidence: 99%

Influenza A Infection Is an Important Cause of Febrile Seizures

et al. 2001

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ABSTRACT. Objectives. To compare the incidence of febrile seizures in children hospitalized for influenza A infection with parainfluenza and adenovirus infection and to examine the hypothesis that children hospitalized for influenza A (variant Sydney/H3N2) during the 1998 season in Hong Kong had more frequent and refractory seizures when compared with other respiratory viruses, including the A/Wuhan H3N2 variant that was present in the previous year.Methods. Medical records of children between 6 months and 5 years of age admitted for influenza A infection in 1998 were reviewed. For comparison, records of children of the same age group with influenza A infection in 1997, and with parainfluenza and adenovirus infections between 1996 and 1998 were reviewed. Children who were afebrile or who had an underlying neurologic disorder were excluded.

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Febrile convulsions in a national cohort followed up from birth. II--Medical history and intellectual ability at 5 years of age.

Cited by 138 publications

References 14 publications

Febrile Seizures: Treatment and Prognosis

Febrile Seizures: Treatment and Prognosis

Febrile Seizures: Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures

Influenza A Infection Is an Important Cause of Febrile Seizures

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