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 - Moshé, 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
N1 - Funding Information:
Supported by National Institute of Neurological Disorders and Stroke ( NS 43209 to S.S.) and Eunice Kennedy Shriver National Institute of Child Health and Human Development ( HD 36867 to D.H.). The authors declare no conflicts of interest.
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.
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U2 - 10.1016/j.jpeds.2013.05.038
DO - 10.1016/j.jpeds.2013.05.038
M3 - Article
C2 - 23809042
AN - SCOPUS:84884670955
SN - 0022-3476
VL - 163
SP - 1147-1151.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 4
ER -