Epilepsy in childhood: findings from the National Child Development Study.

Ross, Euan M.; Cs, Peckham; West, Patrick; Butler, N

doi:10.1136/bmj.280.6209.207

Cited by 167 publications

(110 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent epidemiologic studies have confirmed what most pediatricians have thought for decades, that the vast majority of children with febrile seizures have a benign prognosis and a normal long-term outcome (1)(2)(3)(4)(5)(6)(7). There are, however, still unsolved problems.…”

mentioning

confidence: 78%

“…Adverse outcome may be more related to an underlying preexisting cerebral condition than to the seizure itself (13,14). Even though febrile status appears to have a much better prognosis than hitherto believed (2,4,(14)(15)(16) it should still be considered a major pediatric emergency, requiring fast and aggressive treatment.…”

Section: Short-term Outcomementioning

confidence: 99%

“…The majority of epilepsies after febrile seizures are generalized, idiopathic epilepsies with tonic-clonic seizures (1)(2)(3)(4)(5)(6)(7). A population-based study from Nova Scotia documented that febrile seizures most often precede epilepsy with tonic-clonic seizures, and prolonged febrile seizures rarely precede idiopathic intractable complex partial seizures (93).…”

Section: Febrile Seizures and Type Of Later Epilepsymentioning

confidence: 99%

See 2 more Smart Citations

Febrile Seizures: Treatment and Prognosis

Knudsen

2000

Epilepsia

134

View full text Add to dashboard Cite

Summary: Recent epidemiologic data indicate that the vast majority of children with febrile seizures have a normal long‐term outcome. A precise knowledge of the short‐ and long‐term outcome with or without treatment, and short‐ and long‐term side effects is an important prerequisite for assessing the various treatment strategies. We focus on the impact of short‐term or prophylactic treatment on the short‐ and long‐term outcome of various types of febrile seizures. There is universal agreement that daily prophylaxis with antiepileptic agents should never be used routinely in simple febrile seizures, but only in highly selected cases, if at all. Intermittent diazepam (DZP) prophylaxis at times of fever may or may not reduce the recurrence rate, but it does not appear to improve the long‐term outcome as compared with short‐term seizure control. The treatment may be used to reduce the recurrence rate for a small arbitrarily defined group with multiple simple febrile seizures, complex febrile seizures, especially focal, prolonged or both, febrile status, and when parental anxiety is severe. However, there is no evidence that treatment of simple febrile seizures can prevent the rare cases of later epilepsy, and many children with complex febrile seizures have a benign long‐term outcome, even without treatment. Many prefer a “wait and see” policy. An attractive alternative is to treat new febrile seizures with rectal DZP in solution at seizure onset, given by the parents at home to prevent febrile status. Newer, less well documented short‐term strategies include nasal, oral, or rectal administration of other benzodiazepines. Short‐term seizure control of febrile status and careful parental counseling are the two most important targets of treatment.

show abstract

mentioning

confidence: 78%

Section: Short-term Outcomementioning

confidence: 99%

Section: Febrile Seizures and Type Of Later Epilepsymentioning

confidence: 99%

See 1 more Smart Citation

Febrile Seizures: Treatment and Prognosis

Knudsen

2000

Epilepsia

134

View full text Add to dashboard Cite

show abstract

“…12,13 The present study quantifies the amount that retrospectively collected data underestimates the incidence rate of prospectively collected data (considered to be the accurate rate of FS). 14 However, the difference was significant only for females, which is an observation that is difficult to explain.…”

Section: Discussionmentioning

confidence: 99%

Inconsistency between prospectively and retrospectively reported febrile seizures

Sillanpää

Camfield

et al. 2007

Develop Med Child Neuro

View full text Add to dashboard Cite

This study compared the incidence of febrile seizures (FS) reported prospectively up to 5 years of age, with the prevalence of FS by parental recall in the same cohort using the same questionnaire at 12 years of age. Both prospective and retrospective data were available for 807 children (389 males, 418 females). The number of children reported to have experienced FS in the prospective study was 57, and in the retrospective study was 45, yielding a cumulative incidence of 7.1 and 5.6% respectively. In the retrospective study there was an under-reporting of 19 children, over-reporting of eight children, and one child misreported by age at onset. Overall sensitivity of the retrospective approach was 65% and specificity was 99%. Positive predictive value was 82% and negative predictive value was 97%. Retrospective data underestimate the frequency of FS with high specificity but low sensitivity. Recall data suggest that some children with FS were not reported in the prospective data. These biases should be considered when evaluating the value of FS as a predictor of future health effects.The reported incidence of febrile seizures (FS) in children before the age of 5 years varies widely from 1 to 14%. [1][2][3] In the US and Europe the incidence varies between 2 and 5%. [4][5][6][7][8] In prevalence studies there are many factors that may bias the outcome. One factor is inaccurate reporting. The presence of FS is considered to be an antecedent for many conditions, such as unprovoked seizures. Therefore, it is of importance to learn how valid retrospective FS data are for clinical use as compared with prospective data from the same population.The hypothesis of this study was that the cumulative incidence of FS in a prospective setting would be higher than the prevalence of FS from retrospective data. The incidence of FS derived from the same cohort of children was compared for prospective and retrospective studies. Method PARTICIPANTSIn Finland, public maternity health-care clinics are attended by more than 99% of expectant mothers, and neonates are followed for the first 2 weeks of life in the maternity clinic and thereafter in a well-infant clinic. 9 Collaborating closely with the maternity clinics, the well-infant clinics oversee the follow-up and care of the child from 2 weeks until 7 years of age by a designated public nurse and subsequently by family doctors and nurses. All medical records of the mother and child are transferred from the maternity clinics to the wellinfant clinics.A representative study sample was collected from a southwestern province of Finland (total population 713 000 in 1986) using a standardized, stratified, randomized cluster sampling procedure. Eleven of the 35 health authority areas (the smallest administrative unit of the Finnish public healthcare system) were randomly selected including a total of 67 maternity care clinics and 72 well-infant clinics. The socioeconomic characteristics of the study sample did not significantly differ from the province as a whole.Nulliparous adult female...

show abstract

“…Prior epidemiologic studies of the outcome of febrile seizures in both United States 14 and the United Kingdom 15,16 also have not found differences in global cognitive outcomes between children with febrile seizures and either siblings 14 or population controls, 15,16 but these studies did not specifically examine memory. Interestingly, seizure onset before 1 year of age was also a risk factor for poor outcome in the recent British study.…”

mentioning

confidence: 99%

Do febrile seizures improve memory?

Baram¹,

Shinnar²

2001

Neurology

View full text Add to dashboard Cite

In this issue of Neurology, Chang et al. 1 present a population-based study on the effects of febrile seizures on working memory, and find that school-aged children with febrile seizures performed significantly better than randomly selected, population-based control subjects. However, children with the onset of febrile seizures before the age of 1 year had deficits in learning, consolidation, and delayed recognition.This article extends prior work on this cohort, 2 which found that these school-aged children, except for those with seizure onset under 1 year of age, performed better than populationbased control subjects on measures of intelligence and academic achievement. The new results published in the current article are of particular interest because they focus specifically on learning and memory aspects, which require an intact hippocampus. In both humans 3,4 and immature animal models, 5,6 prolonged febrile seizures have been associated with acute hippocampal injury. Furthermore, a history of prolonged febrile seizures is commonly elicited in individuals with a specific pattern of chronic hippocampal injury, mesial temporal sclerosis, 3,4,7-9 and mesial temporal lobe epilepsy, which are often associated with impaired memory functions. [10][11][12][13] Prior epidemiologic studies of the outcome of febrile seizures in both United States 14 and the United Kingdom 15,16 also have not found differences in global cognitive outcomes between children with febrile seizures and either siblings 14 or population controls, 15,16 but these studies did not specifically examine memory. Interestingly, seizure onset before 1 year of age was also a risk factor for poor outcome in the recent British study. 16 The current study adds reassuring data that memory tasks, which are a more specific indicator of hippocampal function, are preserved in the majority if children with febrile seizures, but raises concern regarding those children who experience these seizures during the first postnatal year.Why be concerned specifically about memory and related hippocampal functions in children with febrile seizures, and what factors might underlie the deficits noted specifically in individuals experiencing the seizures during infancy? Both human 3 and animal 5,6,17 data have suggested recently that at least transient injury to hippocampus and related limbic structures can occur in individuals with prolonged febrile seizures. In human studies, prospective data using neuroimaging methods demonstrated acute swelling of hippocampus after prolonged febrile seizures. 3 In an infant rat model of prolonged (20-minute) febrile seizures, cytoskeletal changes in neurons were evident within 24 hours and persisted for several weeks, without leading to cell loss. 5 However, persistently altered functional

show abstract

Epilepsy in childhood: findings from the National Child Development Study.

Cited by 167 publications

References 13 publications

Febrile Seizures: Treatment and Prognosis

Febrile Seizures: Treatment and Prognosis

Inconsistency between prospectively and retrospectively reported febrile seizures

Do febrile seizures improve memory?

Contact Info

Product

Resources

About