Abstracts

RATIONALE: Febrile convulsions frequently occur in family members and show variable rates of familial aggregation in different studies. Multiple genetic loci are thought to be responsible for the differences which occur in different studies which are reported in separate countries. We sought to determine the rate of familial aggregation of febrile convulsions and epilepsy in a cohort of cases presenting to the Emergency Department METHODS: We reviewed Emergency Department visits to Wake Forest University Baptist Medical Center between Oct. 1,1997 and April 1, 2000 with a discharge diagnosis of febrile convulsions. We identified 192 patients, and charts were reviewed for family history of epilepsy and febrile convulsions. RESULTS: Twenty-four percent(n=47) of patients with febrile convulsions had at least one family member with a positive history of seizures (epilepsy and febrile convulsions). Of family members affected by seizures (n=47), febrile convulsions were found in 79%(n=37), and 21%(n=10) were documented to have other epilepsies. In those with a positive family history of febrile convulsions, 70% had first degree relatives affected and 43% had second degree relative affected. Only 14% of those with family members with febrile convulsions had both first and second degree relatives affected. Of those with first degree relatives affected, 23% had more than one first degree relatives affected. In those with second degree relatives with febrile convulsions, only 18% had multiple second degree relatives affected. 43% of patients with a positive family history of febrile convulsions experienced multiple episodes. CONCLUSIONS: Risk of febrile convulsions in relatives are highly variable, even using this series of cases presenting to an Emergency Department representative of a small geographic region for population basis. The lack of overlap between first and second degree relatives supports a complex mode of inheritance.