PREDICTORS OF RECURRENT FEBRILE SEIZURES - A PROSPECTIVE COHORT STUDY

Objectives: To define the risk and identify predictors of single and m ultiple recurrent febrile seizures. Methods: Children (n=428) with fir st febrile seizures were prospectively identified and followed for 2 o r more years. Parents were interviewed soon after their children's fir st febrile seizure and were called every 3 months to ascertain recurre nt febrile seizures. Medical records of first and recurrent seizures w ere reviewed for additional information. Results: A total of 136 child ren (31.8%) experienced recurrent seizures: 73 (17.1%) had only 1 recu rrence, 38 (8.9%) had 2 recurrences, and 25 (5.8%) had 3 or more recur rences. Young age at onset, a history of febrile seizures in a first-d egree relative, low degree of fever while in the emergency department, and a brief duration between the onset of fever and the initial seizu re were strong independent predictors of recurrent febrile seizures. W ith these 4 factors combined, it is possible to define groups of child ren having very high and very low probabilities of having any recurren ces (>70% vs <20%), having 2 or more recurrences (>60% vs <10%), and h aving 3 or more recurrences (12% vs about 0%). In children who had at least 1 recurrence, age at the time of the first recurrence and a fami ly history of epilepsy were predictors of subsequent recurrences. Conc lusions: In children who have had a first febrile seizure, recurrences are common. The risk for 1 or more recurrences can be meaningfully pr edicted at the time of the initial febrile seizure with a combination of the 4 factors identified in this study.