Background: Febrile seizures (FS) are reported more frequently in the Asian population. Identifying risk factors for the development of FS, would enable parents and health care providers to avoid any preventable factors. There is no data on risk factors for developing febrile seizures in Sri Lankan children.Methods: An unmatched case-control study was performed at the premier children's hospital in the country over a 6-month period. Children aged 6 months to 6 years, who presented with FS (first ever or recurrence), confirmed by a paediatrician, were recruited for the study. The controls were children presenting with a febrile illness not complicated with seizures. History and examination were used to identify any underlying neurological disorder or developmental delay. Interviewer-administered questionnaire, clinic records and haematological investigations were used for risk factor evaluation. Risk of potential variables was assessed by calculating the odds ratio (OR).Results: There were 74 cases and 67 controls. Their corresponding median ages were 28 (IQR 16) and 36 (IQR 48) months. Among cases, 62% presented with simple FS and all others with complex febrile seizures; 5.4% presented in status epilepticus. Thirty-four (50%) presented with their first ever seizure; in the balance it was a recurrence.It was only the family history of febrile seizures (OR=6.27) and low axillary temperature at time of seizure (OR=2.21) that were found to be associated with a significant risk of development of febrile seizures in our patients. Conclusion:This study described the demographics of FS and identified the risk factors for development of FS in Sri Lankan children.

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