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Risk of Epilepsy with Febrile Seizure

November 18, 2019

Written by Clay Smith

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Febrile seizures happened in 3.6% of all Danish children, with about 25% having a second. Risk of long-term epilepsy was 16% after a third febrile seizure and risk of psychiatric disorder went up to 29%.

Why does the matter?
Febrile seizures are common – roughly 5% of all children ages 6 months to 5 years. Do they portend a bad prognosis?

Seize the moment to educate families
In this large population database from Denmark, following over 2.1 million children over a 35 year period, the overall rate of febrile seizure in children 3 months to 5 years was 3.6%. They were more common in boys. Peak risk for boys and girls was at 16 months of age. Risk of subsequent febrile seizure after the first was 23%; after the second, 36%; and after the third, 44%. Risk of long-term epilepsy was 2.2% at baseline for the population and went up to 6.4% after the first febrile seizure, 10.8% after the second, and 15.8% after the third. In other words, there was a roughly 3-fold, 5-fold, and 7-fold increase in risk. Risk of developing a psychiatric disorder was 17% at baseline and went up to 29% after a third febrile seizure. Risk of mortality went up in children with third febrile seizure who went on to develop epilepsy: 1% baseline to 1.9%. This is helpful and important information for families. We can tell them with confidence that febrile seizures are common: 2-5% of all children. Roughly one-quarter will have a second febrile seizure. And about 1 in 6 will develop long-term epilepsy after a third febrile seizure.

Evaluation of Long-term Risk of Epilepsy, Psychiatric Disorders, and Mortality Among Children With Recurrent Febrile Seizures: A National Cohort Study in Denmark. JAMA Pediatr. 2019 Oct 7. doi: 10.1001/jamapediatrics.2019.3343. [Epub ahead of print]

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