DOI QR코드

DOI QR Code

Epilepsy in children with a history of febrile seizures

  • Lee, Sang Hyun (Department of Pediatrics, Korea University College of Medicine) ;
  • Byeon, Jung Hye (Department of Pediatrics, Korea University College of Medicine) ;
  • Kim, Gun Ha (Department of Pediatrics, Korea University College of Medicine) ;
  • Eun, Baik-Lin (Department of Pediatrics, Korea University College of Medicine) ;
  • Eun, So-Hee (Department of Pediatrics, Korea University College of Medicine)
  • 투고 : 2015.06.16
  • 심사 : 2015.09.26
  • 발행 : 2016.02.15

초록

Purpose: Febrile seizure, the most common type of pediatric convulsive disorder, is a benign seizure syndrome distinct from epilepsy. However, as epilepsy is also common during childhood, we aimed to identify the prognostic factors that can predict epilepsy in children with febrile seizures. Methods: The study comprised 249 children at the Korea University Ansan Hospital who presented with febrile seizures. The relationship between the subsequent occurrence of epilepsy and clinical factors including seizure and fever-related variables were analyzed by multivariate analysis. Results: Twenty-five patients (10.0%) had additional afebrile seizures later and were diagnosed with epilepsy. The subsequent occurrence of epilepsy in patients with a history of febrile seizures was associated with a seizure frequency of more than 10 times during the first 2 years after seizure onset (P<0.001). Factors that were associated with subsequent occurrence of epilepsy were developmental delay (P<0.001), preterm birth (P =0.001), multiple seizures during a febrile seizure attack (P =0.005), and epileptiform discharges on electroencephalography (EEG) (P =0.008). Other factors such as the age at onset of first seizure, seizure duration, and family history of epilepsy were not associated with subsequent occurrence of epilepsy in this study. Conclusion: Febrile seizures are common and mostly benign. However, careful observation is needed, particularly for prediction of subsequent epileptic episodes in patients with frequent febrile seizures with known risk factors, such as developmental delay, history of preterm birth, several attacks during a febrile episode, and epileptiform discharges on EEG.

키워드

참고문헌

  1. Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis, International League Against Epilepsy. Epilepsia 1993;34:592-6. https://doi.org/10.1111/j.1528-1157.1993.tb00433.x
  2. Camfield PR, Camfield CS, Dooley JM, Tibbles JA, Fung T, Garner B. Epilepsy after a first unprovoked seizure in childhood. Neurology 1985;35:1657-60. https://doi.org/10.1212/WNL.35.11.1657
  3. Shinnar S, Berg AT, O'Dell C, Newstein D, Moshe SL, Hauser WA. Predictors of multiple seizures in a cohort of children prospectively followed from the time of their first unprovoked seizure. Ann Neurol 2000;48:140-7. https://doi.org/10.1002/1531-8249(200008)48:2<140::AID-ANA2>3.0.CO;2-Y
  4. Dubé CM, Brewster AL, Baram TZ. Febrile seizures: mechanisms and relationship to epilepsy. Brain Dev 2009;31:366-71. https://doi.org/10.1016/j.braindev.2008.11.010
  5. Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316:493-8. https://doi.org/10.1056/NEJM198702263160901
  6. Berg AT, Shinnar S. Unprovoked seizures in children with febrile seizures: short-term outcome. Neurology 1996;47:562-8. https://doi.org/10.1212/WNL.47.2.562
  7. Verity CM, Golding J. Risk of epilepsy after febrile convulsions: a national cohort study. BMJ 1991;303:1373-6. https://doi.org/10.1136/bmj.303.6814.1373
  8. Sapir D, Leitner Y, Harel S, Kramer U. Unprovoked seizures after complex febrile convulsions. Brain Dev 2000;22:484-6. https://doi.org/10.1016/S0387-7604(00)00187-X
  9. Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976;295:1029-33. https://doi.org/10.1056/NEJM197611042951901
  10. Berg AT, Shinnar S, Levy SR, Testa FM. Childhood-onset epilepsy with and without preceding febrile seizures. Neurology 1999;53:1742-8. https://doi.org/10.1212/WNL.53.8.1742
  11. Camfield P, Camfield C, Gordon K, Dooley J. What types of epilepsy are preceded by febrile seizures? A population-based study of children. Dev Med Child Neurol 1994;36:887-92.
  12. Hamati-Haddad A, Abou-Khalil B. Epilepsy diagnosis and localization in patients with antecedent childhood febrile convulsions. Neurology 1998;50:917-22. https://doi.org/10.1212/WNL.50.4.917
  13. Neligan A, Bell GS, Giavasi C, Johnson AL, Goodridge DM, Shorvon SD, et al. Long-term risk of developing epilepsy after febrile seizures: a prospective cohort study. Neurology 2012;78:1166-70. https://doi.org/10.1212/WNL.0b013e31824f807a
  14. Hwang G, Kang HS, Park SY, Han KH, Kim SH. Predictors of unprovoked seizure after febrile seizure: short-term outcomes. Brain Dev 2015;37:315-21. https://doi.org/10.1016/j.braindev.2014.06.003
  15. Pavlidou E, Panteliadis C. Prognostic factors for subsequent epilepsy in children with febrile seizures. Epilepsia 2013;54:2101-7. https://doi.org/10.1111/epi.12429
  16. Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures. Pediatrics 1978;61:720-7.
  17. Vestergaard M, Pedersen CB, Sidenius P, Olsen J, Christensen J. The long-term risk of epilepsy after febrile seizures in susceptible subgroups. Am J Epidemiol 2007;165:911-8. https://doi.org/10.1093/aje/kwk086
  18. Ju HO, McElmurry BJ, Park CG, McCreary L, Kim M, Kim EJ. Anxiety and uncertainty in Korean mothers of children with febrile convulsion: cross-sectional survey. J Clin Nurs 2011;20:1490-7. https://doi.org/10.1111/j.1365-2702.2010.03496.x
  19. Loddenkemper T. Febrile status epilepticus: time is of the essence. Epilepsy Curr 2014;14:345-7. https://doi.org/10.5698/1535-7597-14.6.345
  20. Patterson KP, Baram TZ, Shinnar S. Origins of temporal lobe epilepsy: febrile seizures and febrile status epilepticus. Neurotherapeutics 2014;11:242-50. https://doi.org/10.1007/s13311-014-0263-4
  21. Nishiyama M, Nagase H, Tanaka T, Fujita K, Maruyama A, Toyoshima D, et al. Demographics and outcomes of patients with pediatric febrile convulsive status epilepticus. Pediatr Neurol 2015;52:499-503. https://doi.org/10.1016/j.pediatrneurol.2015.02.001
  22. Kanemura H, Sano F, Mizorogi S, Aoyagi K, Sugita K, Aihara M. Duration of recognized fever in febrile seizure predicts later development of epilepsy. Pediatr Int 2012;54:520-3. https://doi.org/10.1111/j.1442-200X.2012.03599.x
  23. Nordli DR Jr, Moshé SL, Shinnar S, Hesdorffer DC, Sogawa Y, Pellock JM, et al. Acute EEG findings in children with febrile status epilepticus: results of the FEBSTAT study. Neurology 2012;79:2180-6. https://doi.org/10.1212/WNL.0b013e3182759766
  24. Scott RC, King MD, Gadian DG, Neville BG, Connelly A. Hippocampal abnormalities after prolonged febrile convulsion: a longitudinal MRI study. Brain 2003;126(Pt 11):2551-7. https://doi.org/10.1093/brain/awg262
  25. Rocca WA, Sharbrough FW, Hauser WA, Annegers JF, Schoenberg BS. Risk factors for complex partial seizures: a population-based case-control study. Ann Neurol 1987;21:22-31. https://doi.org/10.1002/ana.410210106
  26. Blume WT, Luders HO, Mizrahi E, Tassinari C, van Emde Boas W, Engel J Jr. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Epilepsia 2001;42:1212-8.
  27. van Stuijvenberg M, de Vos S, Tjiang GC, Steyerberg EW, Derksen- Lubsen G, Moll HA. Parents' fear regarding fever and febrile seizures. Acta Paediatr 1999;88:618-22. https://doi.org/10.1080/08035259950169260
  28. Kanemura H, Mizorogi S, Aoyagi K, Sugita K, Aihara M. EEG characteristics predict subsequent epilepsy in children with febrile seizure. Brain Dev 2012;34:302-7. https://doi.org/10.1016/j.braindev.2011.07.007

피인용 문헌

  1. Prognostic factors for epilepsy following first febrile seizure in Saudi children vol.37, pp.6, 2016, https://doi.org/10.5144/0256-4947.2017.449
  2. Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures vol.33, pp.12, 2018, https://doi.org/10.1177/0883073818787064
  3. Epilepsy in Children After Pandemic Influenza Vaccination vol.141, pp.3, 2018, https://doi.org/10.1542/peds.2017-0752
  4. Febrile seizures: an overview vol.7, pp.None, 2016, https://doi.org/10.7573/dic.212536
  5. Experimental Therapeutic Strategies in Epilepsies Using Anti-Seizure Medications vol.13, pp.None, 2016, https://doi.org/10.2147/jep.s267029