Long-term outcome in children presenting with febrile seizures: 25 year follow-up of a general population cohort
Abstract number :
2.084
Submission category :
15. Epidemiology
Year :
2011
Submission ID :
14820
Source :
www.aesnet.org
Presentation date :
12/2/2011 12:00:00 AM
Published date :
Oct 4, 2011, 07:57 AM
Authors :
G. S. Bell, A. Neligan, C. Giavasi, A. L. Johnson, D. M. Goodridge, S. D. Shorvon, J. W. Sander
Rationale: To investigate the long-term prognosis of children in the community presenting with febrile seizures. Methods: The UK National General Practice Study of Epilepsy was set up in the 1980s. Family Physicians completed questionnaires referring to the study all people presenting with a first suspected epileptic seizure (the index seizure). Six months after presentation, an expert panel using all available information, including detailed eye-witness accounts of the episodes, clinical course and investigations, classified the seizures as definite epilepsy, possible epilepsy, febrile seizures or not epilepsy. Children with febrile seizures were initially followed for two years after the close of recruitment with another follow-up in 1997-1998 and a further follow-up in 2009-2010. Age specific incidence rates for epilepsy reported in the British National Child Development Study cohort (Kurtz et al., 1998) (with ages 24 to 30 years extrapolated from age 23 years) were used to calculate the number of people with epilepsy expected.Results: 220 children (133 boys) were classified as having febrile seizures only. At the latest follow-up, 219 were still alive. Two thirds had had no further seizures following the index seizure. Of the 181 with follow-up after more than 20 years, 175 (96.7%) had been seizure free in the preceding 5 years while 171 (94.5%) were seizure free and off anti-epileptic drugs. At 20 years after the index febrile seizure, the estimated percentage who had developed epilepsy was 6.7% (95% Confidence Interval [CI] 4, 11%). The overall Standardized Incidence Ratio (SIR) for developing epilepsy was 9.7 (95% CI 5.8, 16.4). The SIR was highest in children aged 0 to 10 years (up to ten years follow-up), decreasing with age, and was no longer significant in those aged 15 to 20 years (after 10 to 20 years of follow-up).Conclusions: Most children presenting for the first time with a febrile seizure have no further seizures. Children with febrile seizures are almost ten times more likely to develop epilepsy than their peers, yet only seven percent develop epilepsy. Numbers in this study are small, and these data need confirmation.
Epidemiology