At. Berg et al., PREDICTORS OF RECURRENT FEBRILE SEIZURES - A PROSPECTIVE COHORT STUDY, Archives of pediatrics & adolescent medicine, 151(4), 1997, pp. 371-378
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.