Neurodevelopmental problems should be considered in children with febrile seizures

Abstract

Aim: Clinical developmental phenotyping of four-to five-year-old children with febrile seizures (FSs).Methods: Children with FS (n = 157, corresponding to 3.7% of the targeted general population of four-five-year-olds) had been identified at child healthcare centres in Gothenburg. Parents of 73 children (41 boys, 32 girls) accepted participation in the present study. The assessments included a neuropaediatric assessment, Movement ABC, Wechsler Preschool and Primary Scale of Intelligence-III and parent questionnaires (Five-to-Fifteen (FTF) and Strengths and Difficulties Questionnaire (SDQ)). Hospital records were reviewed, when applicable. Results:One-third of the children had at least one DSM-5 neurodevelopmental disorder diagnosis or marked developmental problems within areas of attention, activity regulation, behaviour, speech and language, general cognition or motor functioning. No differences were found between children with single vs recurrent or simple vs complex FS.Conclusion: Febrile seizure are relatively often associated with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCEs). We found no indications that ESSENCE might be caused by FS per se. However, the results suggest that child healthcare professionals should consider the possibility of ESSENCE in children with a history of FS.

Cognitive functioning in a representative cohort of preschool children with febrile seizures

“…Also, the results from visual memory test were within the normal range (NEPSY test), and the results of the immediate recognition test were even above the norms. Interestingly, 17% of study children were considered to have memory problems on the Five‐to‐Fifteen questionnaire as reported by parents in our previous study . This topic is in need of further research, including longer follow‐up.…”

“…Of the 73 children, 25 (34%) met criteria for at least one neurodevelopmental disorder (ID, ADHD, speech and language disorder, developmental coordination disorder), reported in our previous study …”

“…The sample was drawn from the general population of 4‐year‐old children born between July 1, 2008 and June 30, 2009, attending their health check‐up at the age of 4 years between July 1, 2012 and June 30, 2013 at child healthcare centres in Gothenburg, Sweden. At this 4‐year‐check‐up, parents of a total of 6076 children were asked to fill in a questionnaire pertaining to occurrences of FS and, or epilepsy in their child, and 4290 (71%) questionnaires were returned . FS had occurred in 157 children (3.7%) and epilepsy in 22 (0.5%).…”

“…Our previously published clinical study included assessments of the child's type of FS, number of FS, age at first FS, later epilepsy, the child's general medical history and about any previously diagnosed developmental disorder . When possible, data about FS were confirmed in the child's clinical records.…”

“…Each participating child also had an in‐depth neuropsychological assessment. The neuropsychological assessments were performed by a neuropsychologist or a psychology student, under the direct supervision of an experienced neuropsychologist . The results from these assessments are reported in the present study.…”