Febrile Seizures: Clinical Characteristics and Initial EEG

Sofijanov, N; Emoto, Sherrie E.; Kuturec, Marija; Dukovski, M; Duma, Filip; Ellenberg, Jonas H.; Hirtz, Deborah; Nelson, Karin B.

doi:10.1111/j.1528-1157.1992.tb02282.x

Cited by 52 publications

(42 citation statements)

References 9 publications

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“…Presence of focal slowing or attenuation on an EEG following FSE has been associated with subsequent development of epilepsy but has not been associated with an increased risk of recurrent FS, and these results are consistent with the available literature 20; 21 .…”

Section: Discussionsupporting

confidence: 89%

Risk factors for subsequent febrile seizures in the FEBSTAT study

et al. 2016

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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 five 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 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 HR=2.9, p<0.05). The risk for a second FS of any type or of subsequent FS lasting >10 minutes over the five-year follow-up did not differ in FSE versus SFS. Rectal diazepam was administered at home to 5 of 21 children (23.8%) with subsequent FS lasting ≥10 minutes. 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 minutes 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.

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Section: Discussionsupporting

confidence: 89%

Risk factors for subsequent febrile seizures in the FEBSTAT study

et al. 2016

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“…However, it is part of the diagnostic evaluation of children with status epilepticus of all causes including FSE [112]. In cases of complex febrile seizures, EEG abnormalities are more common but their significance remains unclear [113][114][115][116]. A limitation of the prior studies is that they lacked imaging data to correlate with the EEG findings.…”

Section: Eeg As a Potential Predictive Marker For Tle That Follows Fsementioning

confidence: 99%

Origins of Temporal Lobe Epilepsy: Febrile Seizures and Febrile Status Epilepticus

2014

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Temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS) commonly arise following early-life long seizures, and especially febrile status epilepticus (FSE). However, there are major gaps in our knowledge regarding the causal relationships of FSE, TLE, HS and cognitive disturbances that hamper diagnosis, biomarker development and prevention. The critical questions include: What is the true probability of developing TLE after FSE? Are there predictive markers for those at risk? A fundamental question is whether FSE is simply a marker of individuals who are destined to develop TLE, or if FSE contributes to the risk of developing TLE. If FSE does contribute to epileptogenesis, then does this happen only in the setting of a predisposed brain? These questions are addressed within this review, using information gleaned over the past two decades from clinical studies as well as animal models.

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“…Certamente a influência da idade é importante para explicar o achado bastante variável de AE nos vários estudos. 21,23,31,33 Nesta pesquisa se observou correlação estatisticamente significativa entre o tipo de CF e a ocorrência de AE, como referido em alguns estudos na literatura. 31,33 A ocorrência de PE em 3,4% das crianças com CF, de modo semelhante ao referido em estudo anterior, decorre de hiperexcitabilidade cortical ligada a um mecanismo funcional, não lesional, idade dependente e, freqüente em várias síndromes epilépticas, parciais idiopáticas ou sintomáticas e generalizadas, 13,16 mas na maioria das vezes, em crianças sem sinais de lesão cerebral, ou sem manifestações epilépticas e, mesmo em crianças normais.…”

Section: Discussão 1 Aspectos Clínicos E Eletrencefalográficosunclassified

“…7,9,20 Atividade epileptiforme A ocorrência de AE, no EEG, em porcentagem crescente, de acordo com a idade da criança está em acordo com outras pesquisas. 23,31,33 É importante assinalar que a AE assim como a PE aumentam em freqüência quando as CF não mais ocorrem o que sugere condição de hiperexcitabilidade neuronal mais duradoura. Não há estudos dirigidos a esse aspecto evolutivo particular das crianças com CF no sentido de avaliar possíveis repercussões no comportamento e cognição dessa hiperexcitabilidade neuronal.…”

Section: Aspectos Evolutivosunclassified

Crise febril: correlação clínico-eletrencefalográfica em 1162 crianças

Fonseca

2007

J. epilepsy clin. neurophysiol.

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RESUMOIntrodução: Crise febril (CF) é comum, e ocorre em aproximadamente 2 a 5% das crianças até 5 anos de idade. Objetivo e Métodos: Avaliar a relação entre aspectos clínicos e ocorrência de atividade epileptiforme (AE) no eletrencefalograma (EEG) em crianças com CF e, naquelas em que houve seguimento, observar, também, o aparecimento de crises epilépticas não febris (CNF). Resultados: Foram avaliadas 1162 crianças de 4 meses a 5 anos de idade. Houve predomínio de CF simples (82,4%) e de episódio único (62,0%). Houve maior recorrência de CF quando a primeira crise ocorreu antes dos 12 meses de idade ou quando era complexa. AE foi encontrada em porcentagem crescente com a idade da criança; em 3% dos pacientes até os dois anos de idade e 33% após os 4 anos. Pontas evocadas pela percussão de pés ou mãos (PE) ocorreu em 3,4% dos casos. CNF foi relatada em 38 (9,5%) crianças. Não houve correlação estatisticamente significativa entre o tipo e número de CF, idade de ocorrência da primeira CF, presença de AE e de PE no EEG e a ocorrência ou o tipo de CNF, no seguimento. Discussão: Há aspectos ainda controversos na literatura, como o prognóstico em relação ao desenvolvimento de epilepsia e o eventual efeito de AE persistente quanto à cognição e comportamento nas crianças que apresentam CF, a exigir pesquisas prospectivas longitudinais.Unitermos: crise febril, atividade epileptiforme, eletrencefalograma, crise não febril. ABSTRACT Febrile seizures: clinical-electroencephalographic correlation in 1162 childrenIntroduction: Febrile seizures (FS) occur in about 2-5% of the children from the age of 6 months do 5 years of age. Objective: The aim of this study is to analyze clinical and EEG aspects of children with febrile seizures. Methods: We retrospectively studied 1162 children (age range: 4 months to 5 years) with FS. The relationship between clinical and EEG abnormalities was statistically analyzed. Results: In the majority of cases there were simple febrile seizures (82%) and unique seizures (62%). The recurrence rate of FS was higher for children with the first seizure bellow 12 months of age, and when the FS were complicated. Ninetyfive (8.1%) children showed focal epileptiform activity (EA) in the first EEG, and 3.4% had somatosensory evoked spikes by foot or hand stimulation. There was a increase in percentage of EA with the increase of age (3% until 12 months and 33% after 48 moths). Afebrile seizures subsequent to the FS occurred in 9,4% of the cases. EA, a family history of seizures, and the type of FS were not significant risk factors for subsequent afebrile seizures. Discussion: In order to understand the relationship between FS and the occurrence of epilepsy, and to evaluate possible cognitive and behaviour problems associated to the persistent epileptiform activity there is a need of longitudinal studies.

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Febrile Seizures: Clinical Characteristics and Initial EEG

Cited by 52 publications

References 9 publications

Risk factors for subsequent febrile seizures in the FEBSTAT study

Risk factors for subsequent febrile seizures in the FEBSTAT study

Origins of Temporal Lobe Epilepsy: Febrile Seizures and Febrile Status Epilepticus

Crise febril: correlação clínico-eletrencefalográfica em 1162 crianças

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