Identifying complex features of febrile seizures: Medical record review versus medical record plus interview

Complex febrile seizures are associated with an increased risk of epilepsy; however, the means by which complex features are identified are unclear and frequently not discussed. In this report, a comparison is made between the identification of complex features based on medical record review only versus with additional information from an interview with the witness of the seizures. Three pediatric neurologists each rated the descriptions of 100 febrile seizures for the presence of three "complex" features (focal onset, duration > 10 min, and multiple seizures within an illness episode). Ratings were done, first, on a description based solely on information available in the medical record and, second, on a description that included additional information obtained during an interview with the parent. The proportion of seizures with each complex feature was greater with the addition of the interview information than when the raters had the information from the medical record only. Reasons for the differences between records alone and records with interview include omission of information from the record, clarification of medical record information by the interview, and frank disagreements between the record and interview. For identification of complex features, information is needed both from the medical record and an interview with a witness.