Risk factors for subsequent febrile seizures in the FEBSTAT study

the FEBSTAT study team

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: To identify risk and risk factors for developing a subsequent febrile seizure (FS) in children with a first febrile status epilepticus (FSE) compared to a first simple febrile seizure (SFS). To identify home use of rescue medications for subsequent FS. Methods: Cases included a first FS that was FSE drawn from FEBSTAT and Columbia cohorts. Controls were a first SFS. Cases and controls were classified according to established FEBSTAT protocols. Cumulative risk for subsequent FS over a 5-year period was compared in FSE versus SFS, and Cox proportional hazards regression was conducted. Separate analysis examined subsequent FS within FSE. The use of rescue medications at home was assessed for subsequent FS. Results: Risk for a subsequent FSE was significantly increased in FSE versus SFS. Any magnetic resonance imaging (MRI) abnormality increased the risk 3.4-fold (p <0.05), adjusting for age at first FS and FSE and in analyses restricted to children whose first FS was FSE (any MRI abnormality hazard ratio [HR] 2.9, p <0.05). The risk for a second FS of any type or of subsequent FS lasting >10 min over the 5-year follow-up did not differ in FSE versus SFS. Rectal diazepam was administered at home to 5 (23.8%) of 21 children with subsequent FS lasting ≥10 min. Significance: Compared to controls, FSE was associated with an increased risk for subsequent FSE, suggesting the propensity of children with an initial prolonged seizure to experience a prolonged recurrence. Any baseline MRI abnormality increased the recurrence risk when FSE was compared to SFS and when FSE was studied alone. A minority of children with a subsequent FS lasting 10 min or longer were treated with rectal diazepam at home, despite receiving prescriptions after the first FSE. This indicates the need to further improve the education of clinicians and parents in order to prevent subsequent FSE.

Original languageEnglish (US)
Pages (from-to)1042-1047
Number of pages6
JournalEpilepsia
Volume57
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Febrile Seizures
Status Epilepticus
Fever
Diazepam
Magnetic Resonance Imaging
Recurrence

Keywords

  • Febrile seizure recurrence
  • Simple febrile seizure
  • Status epilepticus

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Risk factors for subsequent febrile seizures in the FEBSTAT study. / the FEBSTAT study team.

In: Epilepsia, Vol. 57, No. 7, 01.07.2016, p. 1042-1047.

Research output: Contribution to journalArticle

the FEBSTAT study team. / Risk factors for subsequent febrile seizures in the FEBSTAT study. In: Epilepsia. 2016 ; Vol. 57, No. 7. pp. 1042-1047.
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abstract = "Objectives: To identify risk and risk factors for developing a subsequent febrile seizure (FS) in children with a first febrile status epilepticus (FSE) compared to a first simple febrile seizure (SFS). To identify home use of rescue medications for subsequent FS. Methods: Cases included a first FS that was FSE drawn from FEBSTAT and Columbia cohorts. Controls were a first SFS. Cases and controls were classified according to established FEBSTAT protocols. Cumulative risk for subsequent FS over a 5-year period was compared in FSE versus SFS, and Cox proportional hazards regression was conducted. Separate analysis examined subsequent FS within FSE. The use of rescue medications at home was assessed for subsequent FS. Results: Risk for a subsequent FSE was significantly increased in FSE versus SFS. Any magnetic resonance imaging (MRI) abnormality increased the risk 3.4-fold (p <0.05), adjusting for age at first FS and FSE and in analyses restricted to children whose first FS was FSE (any MRI abnormality hazard ratio [HR] 2.9, p <0.05). The risk for a second FS of any type or of subsequent FS lasting >10 min over the 5-year follow-up did not differ in FSE versus SFS. Rectal diazepam was administered at home to 5 (23.8{\%}) of 21 children with subsequent FS lasting ≥10 min. Significance: Compared to controls, FSE was associated with an increased risk for subsequent FSE, suggesting the propensity of children with an initial prolonged seizure to experience a prolonged recurrence. Any baseline MRI abnormality increased the recurrence risk when FSE was compared to SFS and when FSE was studied alone. A minority of children with a subsequent FS lasting 10 min or longer were treated with rectal diazepam at home, despite receiving prescriptions after the first FSE. This indicates the need to further improve the education of clinicians and parents in order to prevent subsequent FSE.",
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AU - Hesdorffer, Dale C.

AU - Shinnar, Shlomo

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AU - Pellock, John M.

AU - Nordli, Douglas R.

AU - Seinfeld, Syndi

AU - Gallentine, William

AU - Frank, L. Matthew

AU - Lewis, Darrell V.

AU - Shinnar, Ruth C.

AU - Bello, Jacqueline A.

AU - Chan, Stephen

AU - Epstein, Leon G.

AU - Moshe, Solomon L.

AU - Liu, Binyi

AU - Sun, Shumei

AU - Berman, Evelyn

AU - Gomes, William

AU - Gomes, William A.

AU - Katz, Sharyn

AU - Mancini, Ann

AU - Masur, David

AU - Sogawa, Yoshimi

AU - Weiss, Erica

AU - Weiss, Erica F.

AU - Cornett, Karen

AU - MacFall, James

AU - Provenzale, James

AU - Song, Allen

AU - Voyvodic, James

AU - Xu, Yuan

AU - Andy, Joanne

AU - Conklin, Terrie

AU - Grasso, Susan

AU - Powers, Connie S.

AU - Kushner, David

AU - Landers, Susan

AU - Van de Water, Virginia

AU - Bush, Brian J.

AU - Davis, Lori L.

AU - Deng, Xiaoyan

AU - Rogers, Christiane

AU - Sabo, Cynthia Shier

AU - Curran, John

AU - Kim, Andrew

AU - Miazga, Diana

AU - Rinaldi, Julie

AU - Bagiella, Emilia

AU - Brazemore, Tanya

AU - Culbert, James

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N2 - Objectives: To identify risk and risk factors for developing a subsequent febrile seizure (FS) in children with a first febrile status epilepticus (FSE) compared to a first simple febrile seizure (SFS). To identify home use of rescue medications for subsequent FS. Methods: Cases included a first FS that was FSE drawn from FEBSTAT and Columbia cohorts. Controls were a first SFS. Cases and controls were classified according to established FEBSTAT protocols. Cumulative risk for subsequent FS over a 5-year period was compared in FSE versus SFS, and Cox proportional hazards regression was conducted. Separate analysis examined subsequent FS within FSE. The use of rescue medications at home was assessed for subsequent FS. Results: Risk for a subsequent FSE was significantly increased in FSE versus SFS. Any magnetic resonance imaging (MRI) abnormality increased the risk 3.4-fold (p <0.05), adjusting for age at first FS and FSE and in analyses restricted to children whose first FS was FSE (any MRI abnormality hazard ratio [HR] 2.9, p <0.05). The risk for a second FS of any type or of subsequent FS lasting >10 min over the 5-year follow-up did not differ in FSE versus SFS. Rectal diazepam was administered at home to 5 (23.8%) of 21 children with subsequent FS lasting ≥10 min. Significance: Compared to controls, FSE was associated with an increased risk for subsequent FSE, suggesting the propensity of children with an initial prolonged seizure to experience a prolonged recurrence. Any baseline MRI abnormality increased the recurrence risk when FSE was compared to SFS and when FSE was studied alone. A minority of children with a subsequent FS lasting 10 min or longer were treated with rectal diazepam at home, despite receiving prescriptions after the first FSE. This indicates the need to further improve the education of clinicians and parents in order to prevent subsequent FSE.

AB - Objectives: To identify risk and risk factors for developing a subsequent febrile seizure (FS) in children with a first febrile status epilepticus (FSE) compared to a first simple febrile seizure (SFS). To identify home use of rescue medications for subsequent FS. Methods: Cases included a first FS that was FSE drawn from FEBSTAT and Columbia cohorts. Controls were a first SFS. Cases and controls were classified according to established FEBSTAT protocols. Cumulative risk for subsequent FS over a 5-year period was compared in FSE versus SFS, and Cox proportional hazards regression was conducted. Separate analysis examined subsequent FS within FSE. The use of rescue medications at home was assessed for subsequent FS. Results: Risk for a subsequent FSE was significantly increased in FSE versus SFS. Any magnetic resonance imaging (MRI) abnormality increased the risk 3.4-fold (p <0.05), adjusting for age at first FS and FSE and in analyses restricted to children whose first FS was FSE (any MRI abnormality hazard ratio [HR] 2.9, p <0.05). The risk for a second FS of any type or of subsequent FS lasting >10 min over the 5-year follow-up did not differ in FSE versus SFS. Rectal diazepam was administered at home to 5 (23.8%) of 21 children with subsequent FS lasting ≥10 min. Significance: Compared to controls, FSE was associated with an increased risk for subsequent FSE, suggesting the propensity of children with an initial prolonged seizure to experience a prolonged recurrence. Any baseline MRI abnormality increased the recurrence risk when FSE was compared to SFS and when FSE was studied alone. A minority of children with a subsequent FS lasting 10 min or longer were treated with rectal diazepam at home, despite receiving prescriptions after the first FSE. This indicates the need to further improve the education of clinicians and parents in order to prevent subsequent FSE.

KW - Febrile seizure recurrence

KW - Simple febrile seizure

KW - Status epilepticus

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