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Risk factors for subsequent febrile seizures in the FEBSTAT study.

Publication ,  Journal Article
Hesdorffer, DC; Shinnar, S; Lax, DN; Pellock, JM; Nordli, DR; Seinfeld, S; Gallentine, W; Frank, LM; Lewis, DV; Shinnar, RC; Bello, JA; Liu, B ...
Published in: Epilepsia
July 2016

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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Published In

Epilepsia

DOI

EISSN

1528-1167

Publication Date

July 2016

Volume

57

Issue

7

Start / End Page

1042 / 1047

Location

United States

Related Subject Headings

  • Status Epilepticus
  • Seizures, Febrile
  • Risk Factors
  • Regression Analysis
  • Proportional Hazards Models
  • Neurology & Neurosurgery
  • Male
  • Magnetic Resonance Imaging
  • Infant
  • Humans
 

Citation

APA
Chicago
ICMJE
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Hesdorffer, D. C., Shinnar, S., Lax, D. N., Pellock, J. M., Nordli, D. R., Seinfeld, S., … FEBSTAT study team, . (2016). Risk factors for subsequent febrile seizures in the FEBSTAT study. Epilepsia, 57(7), 1042–1047. https://doi.org/10.1111/epi.13418
Hesdorffer, Dale C., Shlomo Shinnar, Daniel N. Lax, John M. Pellock, Douglas R. Nordli, Syndi Seinfeld, William Gallentine, et al. “Risk factors for subsequent febrile seizures in the FEBSTAT study.Epilepsia 57, no. 7 (July 2016): 1042–47. https://doi.org/10.1111/epi.13418.
Hesdorffer DC, Shinnar S, Lax DN, Pellock JM, Nordli DR, Seinfeld S, et al. Risk factors for subsequent febrile seizures in the FEBSTAT study. Epilepsia. 2016 Jul;57(7):1042–7.
Hesdorffer, Dale C., et al. “Risk factors for subsequent febrile seizures in the FEBSTAT study.Epilepsia, vol. 57, no. 7, July 2016, pp. 1042–47. Pubmed, doi:10.1111/epi.13418.
Hesdorffer DC, Shinnar S, Lax DN, Pellock JM, Nordli DR, Seinfeld S, Gallentine W, Frank LM, Lewis DV, Shinnar RC, Bello JA, Chan S, Epstein LG, Moshé SL, Liu B, Sun S, FEBSTAT study team. Risk factors for subsequent febrile seizures in the FEBSTAT study. Epilepsia. 2016 Jul;57(7):1042–1047.
Journal cover image

Published In

Epilepsia

DOI

EISSN

1528-1167

Publication Date

July 2016

Volume

57

Issue

7

Start / End Page

1042 / 1047

Location

United States

Related Subject Headings

  • Status Epilepticus
  • Seizures, Febrile
  • Risk Factors
  • Regression Analysis
  • Proportional Hazards Models
  • Neurology & Neurosurgery
  • Male
  • Magnetic Resonance Imaging
  • Infant
  • Humans