No abstract

To determine the value of a detailed family history for the assessment of the risk of recurrence of febrile seizures, 115 children who visited the emergency room of an academic children's hospital were studied prospectively. Moreover, it is still not possible to discriminate between children who will and children who will not have a recurrence. Further improvements in the ability to predict the recurrence of a febrile seizure will aid doctors in choosing the appropriate prophylactic treatment, if any.A first degree-family history positive for febrile seizures has been shown to be a major risk factor for the recurrence of a febrile seizure in several studies; other risk factors are young age at onset, multiple initial seizures, and relatively low temperature at the initial seizure.47 13The recurrence risks for febrile seizures have been reported in relation to the presence of first degree relatives (parents and siblings) affected by febrile seizures or in relation to the presence of affected relatives of any degree.3 14 15 The predictive value of the presence of affected second and third degree relatives on the recurrence risk of febrile seizures is unknown. Also, the number of a child's relatives has not so far been taken into account. In general, a child's chance of having a family history positive for febrile seizures will be proportional to the number of relatives. Thus children with larger families will be more likely to have a positive family history.'6 An incorporation of the number of relatives in the family history of febrile seizures may yield a more accurate assessment of a child's recurrence risk.We investigated the association between the recurrence of febrile seizures and the presence of affected first degree relatives and the presence of affected second (grandparents, uncles/aunts) or third degree (cousins) relatives separately. We also investigated the recurrence of febrile seizures in children in relation to the proportion of first degree relatives affected.

The cumulative risk of FS in siblings of children with FS is increased. The age attained risk of FS can be estimated using a practical model incorporating three readily available risk factors.

Objective To estimate the potential preventive effect of antipyretic drugs on the recurrence of febrile seizures (FS). Design An experimental and a descriptive patient series, both prospectively followed, were combined in this study. Setting/participants Children who visited the outpatient department of the Sophia Children’s Hospital because of a FS experienced between the age of 10 and 36 months. Intervention A treatment group of 109 children was offered treatment with ibuprofen or acetaminophen syrup during fever, a control group of 103 children was not offered antipyretic treatment. This was not a randomized trial. In an intention‐to‐treat analysis, the risk of any recurrence and the number of recurrences per fever were compared between both groups. In an additional on‐treatment analysis, we compared the number of recurrences per fever between the control group and the children in the treatment group who actually received the study medication during fever. Effect measures were odds ratio (OR) as estimated by the Mantel–Haenszel procedure and hazard ratios (HR) as estimated by Cox regression. Results According to the intention‐to‐treat analysis, the hazard ratio of any recurrence in the treatment group compared with the control group was 1.1 [95% confidence interval (CI), 0.7–1.8]. The recurrence risk per fever was 15% in the treatment group and 12% in the control group (OR, 1.2; 95% CI, 0.7–2.3). In the exploratory on‐treatment analysis, the recurrence risk in the treatment group was estimated 6.9% in the treatment group versus 12% in the control group (OR, 0.5; 95% CI, 0.2–1.3). Conclusions/implications for practice We conclude that antipyretic treatment may have little or no preventive effect on the recurrence of febrile seizures in common practice. Some reduction of the risk of a recurrence may be acquired under optimal circumstances, namely that fever is noticed at once and that antipyretic drugs can be administered on time.