Family history and recurrence of febrile seizures.

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.

Febrile Convulsions in 220 Children – Neurological Sequelae at 12 Years Follow-Up

“…Furthermore, although both daily phenobarbitone and diazepam with fever have been shown to reduce the chances of recurrent FC [14, 17, 41], studies have not demonstrated reduction in subsequent epilepsy [17, 35, 42, 43]. Moreover, prolonged prophylactic treatment has adverse effects [44, 45, 46, 47, 48]. Some authorities advise AEDs for FCs only for ‘frequent recurrences’ [49, 50], if prolonged FCs (over 20 min) occur before age 9 months or after a third FC [51], and others advise them for complex features or in children with neurological deficit.…”

Comparison of family history measures used to identify high risk of coronary heart disease

“…About 20% of families had two or more affected relatives and the scores tended to capture this information. It is worth noting that the formulation of Van Esch et al [1994], simply the proportion of relatives affected, without regard to age or sex, adequately described these data.…”

“…FHS-1, adjusting for family size, improved the fit better than Schwartz et al [1988], the formulations being otherwise identical. The Chakraborty et al [1984] 0.47 0.49 Williams et al [1984] 7.99 0.005 Fain and Goldgar [1986] 4.87 0.03 Lynch et al [1986] 3.97 0.05 Reed et al [1986] 9.32 0.002 Schwartz et al (b) [1988] 0.63 0.43 Groeneveld and Hitzeroth [1991] 9.69 0.002 Kee et al [1991] 0.49 0.48 Van Esch et al (a) [1994] 10.00 0.002 Kerber (a) [1995] 11.54 0.001 Kerber (b) [1995] 11.30 0.001 Kerber (c) [1995] 2.77 0.10 FHS-1 6.01 0.01 FHS-2 11.61 0.001 *One or more first-degree relatives affected before 60 years of age.…”

“…formulation of Van Esch [1994], a simple count adjusted for family size, performed as well as any with these data.…”

Febrile Seizure Prevalence in Children in the Erzurum Provincial Center

“…12,37 Van Esch ve ark., 1. derece akrabalarında FK öyküsü olan çocuklarda, rekürrens riskini %52 olarak bulmuşlardır. 38 Berg ve ark. ise 1.derece akrabalarda FK öyküsü olanlarda rekürrens riskini %45.5, olmayanlarda ise %26,3 olarak belirtmişler-dir.…”