Predictors of recurrent febrile seizures

A metaanalytic review

Anne T. Berg, Shlomo Shinnar, W. Allen Hauser, John M. Leventhal

Research output: Contribution to journalArticle

127 Citations (Scopus)

Abstract

The 1980 National Institutes of Health Consensus Development Conference on Febrile Seizures identified five circumstances in which it might be appropriate to consider anticonvulsant prophylaxis after a first febrile seizure: (1) a focal or prolonged seizure, (2) neurologic abnormalities, (3) afebrile seizures in a firstdegree relative, (4) age less than 1 year, and (5) multiple seizures occurring within 24 hours. We performed a metaanalysis of 14 published reports to evaluate the strength of association between each of these indications and recurrent febrile seizures. Young age at onset (≤1 year) and a family history of febrile seizures (not listed in the recommendations) each distinguished between groups with approximately a 30% versus a 50% risk of recurrence. Family history of afebrile seizures was not consistently associated with an increased risk. Focal, prolonged, and multiple seizures were associated with only a small increment in risk of recurrence. The data were not adequate to assess the risk associated with neurologic abnormalities. By considering children with combinations of risk factors, some studies were able to distinguish between groups with very low and very high recurrence risks. Only age at onset was consistently predictive of having more than one recurrence. These results suggest that the great majority of children who have a febrile seizure do not need anticonvulsant treatment even if one of the factors listed in the Consensus Statement is present, and that the rationale and indications for treating febrile seizures need to be reconsidered.

Original languageEnglish (US)
Pages (from-to)329-337
Number of pages9
JournalThe Journal of Pediatrics
Volume116
Issue number3
DOIs
StatePublished - 1990

Fingerprint

Febrile Seizures
Seizures
Nervous System Malformations
Recurrence
Age of Onset
Anticonvulsants
Consensus Development Conferences
National Institutes of Health (U.S.)
Consensus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Predictors of recurrent febrile seizures : A metaanalytic review. / Berg, Anne T.; Shinnar, Shlomo; Hauser, W. Allen; Leventhal, John M.

In: The Journal of Pediatrics, Vol. 116, No. 3, 1990, p. 329-337.

Research output: Contribution to journalArticle

Berg, Anne T. ; Shinnar, Shlomo ; Hauser, W. Allen ; Leventhal, John M. / Predictors of recurrent febrile seizures : A metaanalytic review. In: The Journal of Pediatrics. 1990 ; Vol. 116, No. 3. pp. 329-337.
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