Risk factors for febrile status epilepticus: A case-control study

Dale C. Hesdorffer, Shlomo Shinnar, Darrell V. Lewis, Douglas R. Nordli, John M. Pellock, Solomon L. Moshe, Ruth C. Shinnar, Claire Litherland, Emilia Bagiella, L. Matthew Frank, Jacqueline A. Bello, Stephen Chan, David Masur, James Macfall, Shumei Sun

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective To identify risk factors for developing a first febrile status epilepticus (FSE) among children with a first febrile seizure (FS). Study design Cases were children with a first FS that was FSE drawn from the Consequences of Prolonged Febrile Seizures in Childhood and Columbia cohorts. Controls were children with a first simple FS and separately, children with a first complex FS that was not FSE. Identical questionnaires were administered to family members of the 3 cohorts. Magnetic resonance imaging protocol and readings were consistent across cohorts, and seizure phenomenology was assessed by the same physicians. Risk factors were analyzed using logistic regression. Results Compared with children with simple FS, FSE was associated with younger age, lower temperature, longer duration (1-24 hours) of recognized temperature before FS, female sex, structural temporal lobe abnormalities, and first-degree family history of FS. Compared with children with other complex FS, FSE was associated with low temperature and longer duration (1-24 hours) of temperature recognition before FS. Risk factors for complex FS that was not FSE were similar in magnitude to those for FSE but only younger age was significant. Conclusions Among children with a first FS, FSE appears to be due to a combination of lower seizure threshold (younger age and lower temperatures) and impaired regulation of seizure duration. Clinicians evaluating FS should be aware of these factors as many episodes of FSE go unnoticed. Further work is needed to develop strategies to prevent FSE.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume163
Issue number4
DOIs
StatePublished - Oct 2013

Fingerprint

Febrile Seizures
Status Epilepticus
Case-Control Studies
Fever
Temperature
Seizures
Temporal Lobe

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Risk factors for febrile status epilepticus : A case-control study. / Hesdorffer, Dale C.; Shinnar, Shlomo; Lewis, Darrell V.; Nordli, Douglas R.; Pellock, John M.; Moshe, Solomon L.; Shinnar, Ruth C.; Litherland, Claire; Bagiella, Emilia; Frank, L. Matthew; Bello, Jacqueline A.; Chan, Stephen; Masur, David; Macfall, James; Sun, Shumei.

In: Journal of Pediatrics, Vol. 163, No. 4, 10.2013.

Research output: Contribution to journalArticle

Hesdorffer, DC, Shinnar, S, Lewis, DV, Nordli, DR, Pellock, JM, Moshe, SL, Shinnar, RC, Litherland, C, Bagiella, E, Frank, LM, Bello, JA, Chan, S, Masur, D, Macfall, J & Sun, S 2013, 'Risk factors for febrile status epilepticus: A case-control study', Journal of Pediatrics, vol. 163, no. 4. https://doi.org/10.1016/j.jpeds.2013.05.038
Hesdorffer, Dale C. ; Shinnar, Shlomo ; Lewis, Darrell V. ; Nordli, Douglas R. ; Pellock, John M. ; Moshe, Solomon L. ; Shinnar, Ruth C. ; Litherland, Claire ; Bagiella, Emilia ; Frank, L. Matthew ; Bello, Jacqueline A. ; Chan, Stephen ; Masur, David ; Macfall, James ; Sun, Shumei. / Risk factors for febrile status epilepticus : A case-control study. In: Journal of Pediatrics. 2013 ; Vol. 163, No. 4.
@article{5122ca211b844788a1c58bbb07c7309f,
title = "Risk factors for febrile status epilepticus: A case-control study",
abstract = "Objective To identify risk factors for developing a first febrile status epilepticus (FSE) among children with a first febrile seizure (FS). Study design Cases were children with a first FS that was FSE drawn from the Consequences of Prolonged Febrile Seizures in Childhood and Columbia cohorts. Controls were children with a first simple FS and separately, children with a first complex FS that was not FSE. Identical questionnaires were administered to family members of the 3 cohorts. Magnetic resonance imaging protocol and readings were consistent across cohorts, and seizure phenomenology was assessed by the same physicians. Risk factors were analyzed using logistic regression. Results Compared with children with simple FS, FSE was associated with younger age, lower temperature, longer duration (1-24 hours) of recognized temperature before FS, female sex, structural temporal lobe abnormalities, and first-degree family history of FS. Compared with children with other complex FS, FSE was associated with low temperature and longer duration (1-24 hours) of temperature recognition before FS. Risk factors for complex FS that was not FSE were similar in magnitude to those for FSE but only younger age was significant. Conclusions Among children with a first FS, FSE appears to be due to a combination of lower seizure threshold (younger age and lower temperatures) and impaired regulation of seizure duration. Clinicians evaluating FS should be aware of these factors as many episodes of FSE go unnoticed. Further work is needed to develop strategies to prevent FSE.",
author = "Hesdorffer, {Dale C.} and Shlomo Shinnar and Lewis, {Darrell V.} and Nordli, {Douglas R.} and Pellock, {John M.} and Moshe, {Solomon L.} and Shinnar, {Ruth C.} and Claire Litherland and Emilia Bagiella and Frank, {L. Matthew} and Bello, {Jacqueline A.} and Stephen Chan and David Masur and James Macfall and Shumei Sun",
year = "2013",
month = "10",
doi = "10.1016/j.jpeds.2013.05.038",
language = "English (US)",
volume = "163",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Risk factors for febrile status epilepticus

T2 - A case-control study

AU - Hesdorffer, Dale C.

AU - Shinnar, Shlomo

AU - Lewis, Darrell V.

AU - Nordli, Douglas R.

AU - Pellock, John M.

AU - Moshe, Solomon L.

AU - Shinnar, Ruth C.

AU - Litherland, Claire

AU - Bagiella, Emilia

AU - Frank, L. Matthew

AU - Bello, Jacqueline A.

AU - Chan, Stephen

AU - Masur, David

AU - Macfall, James

AU - Sun, Shumei

PY - 2013/10

Y1 - 2013/10

N2 - Objective To identify risk factors for developing a first febrile status epilepticus (FSE) among children with a first febrile seizure (FS). Study design Cases were children with a first FS that was FSE drawn from the Consequences of Prolonged Febrile Seizures in Childhood and Columbia cohorts. Controls were children with a first simple FS and separately, children with a first complex FS that was not FSE. Identical questionnaires were administered to family members of the 3 cohorts. Magnetic resonance imaging protocol and readings were consistent across cohorts, and seizure phenomenology was assessed by the same physicians. Risk factors were analyzed using logistic regression. Results Compared with children with simple FS, FSE was associated with younger age, lower temperature, longer duration (1-24 hours) of recognized temperature before FS, female sex, structural temporal lobe abnormalities, and first-degree family history of FS. Compared with children with other complex FS, FSE was associated with low temperature and longer duration (1-24 hours) of temperature recognition before FS. Risk factors for complex FS that was not FSE were similar in magnitude to those for FSE but only younger age was significant. Conclusions Among children with a first FS, FSE appears to be due to a combination of lower seizure threshold (younger age and lower temperatures) and impaired regulation of seizure duration. Clinicians evaluating FS should be aware of these factors as many episodes of FSE go unnoticed. Further work is needed to develop strategies to prevent FSE.

AB - Objective To identify risk factors for developing a first febrile status epilepticus (FSE) among children with a first febrile seizure (FS). Study design Cases were children with a first FS that was FSE drawn from the Consequences of Prolonged Febrile Seizures in Childhood and Columbia cohorts. Controls were children with a first simple FS and separately, children with a first complex FS that was not FSE. Identical questionnaires were administered to family members of the 3 cohorts. Magnetic resonance imaging protocol and readings were consistent across cohorts, and seizure phenomenology was assessed by the same physicians. Risk factors were analyzed using logistic regression. Results Compared with children with simple FS, FSE was associated with younger age, lower temperature, longer duration (1-24 hours) of recognized temperature before FS, female sex, structural temporal lobe abnormalities, and first-degree family history of FS. Compared with children with other complex FS, FSE was associated with low temperature and longer duration (1-24 hours) of temperature recognition before FS. Risk factors for complex FS that was not FSE were similar in magnitude to those for FSE but only younger age was significant. Conclusions Among children with a first FS, FSE appears to be due to a combination of lower seizure threshold (younger age and lower temperatures) and impaired regulation of seizure duration. Clinicians evaluating FS should be aware of these factors as many episodes of FSE go unnoticed. Further work is needed to develop strategies to prevent FSE.

UR - http://www.scopus.com/inward/record.url?scp=84884670955&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884670955&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2013.05.038

DO - 10.1016/j.jpeds.2013.05.038

M3 - Article

C2 - 23809042

AN - SCOPUS:84884670955

VL - 163

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 4

ER -