The value of early postictal EEG in children with complex febrile seizures

Purpose: To assess the usefulness of an early postictal EEG in neurological ly normal children with complex febrile seizures. Methods: We conducted a retrospective chart review of all neurologically no rmal children who were hospitalized over a period of 2.5 years after comple x febrile seizures, and had an EEG up to 1 week after the seizure. Results: Thirty-three patients (mean age, 17.8 months) qualified for inclus ion into the study. Twenty-four patients were qualified as complex cases ba sed on one factor (prolonged in 9, repetitive in 13, and focal in 2). Nine other patients had two complex factors: in six patients, the seizures were long and repetitive; in two patients, the seizures were focal and repetitiv e; and in one patient, the seizures were long, focal, and repetitive. Thirt een (39%) patients experienced prior febrile seizures. All 33 patients had a normal postictal sleep EEG. Our results indicate with a 95% probability t hat the true rate of abnormalities in an early postictal EEG performed on o therwise normal children with complex febrile seizures is 8.6% or less. Conclusions: The yield of abnormalities of an early postictal EEG in this p opulation is low and similar to the reported rate of abnormalities in child ren with simple febrile seizures. The routine practice of obtaining an earl y EEG in neurologically normal children with complex febrile seizures is no t justified.