Etiology and Risk Factors of Febrile Seizure – An Update

Abstract

Febrile seizures (FS) are the most common convulsive event in children. This condition has been described since the time of Hippocrates. The etiology of the febrile seizures are still unclear. In FS, there is a strong familial predisposition. This does not exclude infections as a causative factor because subtle genetic polymorphisms have been demonstrated to affect the course of infections. In an earlier review of the world literature (1924-1964), except for roseola infantum, viral infections as a cause of febrile seizures were rarely diagnosed. Reports of viral infections in the etiology of febrile seizures have increased in number in the past decade. In the first half of the twentieth century, infections identified with febrile seizures were mainly upper respiratory in type and the etiologic agent was unknown or bacterial. We review i) the role of infection – viral and bacterial; ii) the role of genetic and environmental factors; iii) the role of electrolyte and metabolic factors; and iv) the role of cytokines. With the help of new diagnostic tools such as PCR, the viral agents are detected in CSF far more often than previously thought, even in the absence of pleocytosis of the CSF. This makes it difficult to distinguish FS from acute encephalitis. FS may be caused by neuroinvasion or intracerebral activation of viruses. By reviewing etiology and risk factors of FS we can identify the points to be focused in therapeutic interventions and trials and also the fields of future studies will be explored. DOI: http://dx.doi.org/10.3329/bjch.v34i3.10361 BJCH 2010; 34(3): 103-112

Knowledge and Attitude on Febrile Seizure among Mothers with Under-Five Children

“…According to other studies, seizure most commonly occurs when children have risk factors such as upper respiratory infection and acute otitis media, parental history of febrile seizure, neonatal hospitalization >30 days, and delayed development. 5,6 On the contrary, one study reported by Parmar et al 7 in Mumbai, India stated that 77.9% parents do not know that seizure can occur during one febrile occasion.…”

“…4 The most common disease that triggers a febrile seizure is ear infections of any cold or viral infection. 5 A febrile seizure can be very frightening for parents. 2 In consequence, parents' ignorance and poor understanding about how to deal with seizure and their anxiety will lead to mismanagement of febrile seizure.…”

Role of serum sodium levels in recurrence and recurrent episodes of febrile seizure

“…Siblings with history of Febrile Seizure ,showed 10-20% of recurrences. 6 An autosomal dominant inheritance pattern, where found in genes encoding the sodium channel and the gamma amino-butyric acid receptor A. 7 Percentage of recurrence, if one of the parents had history of Febrile Seizure chance of recurrence is about 40%.…”

Proinflammatory and anti-inflammatory cytokines in febrile seizures and epilepsy: systematic review and meta-analysis

“…FS, the most common type of epileptic seizures in early life world wide (Nakayama and Arinami, 2006;Kundu et al, 2012;Salzmann et al, 2012), is a matter of concern to pediatricians with a total prevalence of 3%-7% in children up to 7 years (Cross, 2012) and a cumulative incidence of 2%-5% in the first 5 years of life (Verity et al, 1985;Visser et al, 2012). FS, occurring during rapid rising of fever (Özaydın et al, 2012) between 6 months and 5 years of age (Klein et al, 2012;Kumari et al, 2012;Martinos et al, 2012;Teran et al, 2012;Zareifar et al, 2012), can be divided into simple forms (only occuring once in 24 h, generalized, and duration < 15 min) and complex forms (recurrent during 24 h, focal, and duration > 15 min) (Kira et al, 2005;Abdel Rasol et al, 2012;French, 2012;Offringa and Newton, 2013;Sasidaran et al, 2012;Scott et al, 2012;Yu et al, 2012).…”