Recurrence risk after a first febrile convulsion

OBJECTIVE: Fever is the most common cause of convulsions, in infancy and childhood. Parents usually are concerned by the risk of recurrence. Our aim is to determine this risk of subsequent convulsions within the first year of the first episode of convulsion.

METHODS: This is a prospective study over one year, May 97 to April 98 in which all children with first febrile seizure were enrolled.

RESULTS: There were two hundred and thirty six children who had their first febrile convulsion within the study period. Male-to-female ratio was 1.2:1; the mean age at onset was 19 months (standard deviation 14.4). Generalized seizure occurred in 95.6% of the patients with an average duration of 7 minutes (SD 6.4). Ten percent of patients needed anticonvulsant drugs to stop convulsion. Seizure clusters occurred in 13.6 %, and complex febrile seizure was noticed in 21%. Family history was positive for epilepsy in 6.6% and febrile convulsions in 22%. Recurrence within a year from onset occurred in 52 (21%) of the patients. Factors associated with recurrence were: male sex, as male to female ratio was 2.25:1 (P=0.02) and history of seizure clusters, 23/52, 44% (P= 0.00001).

CONCLUSION: Risk factors for recurrence noted were male sex, and complex febrile seizures.