Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures

Kavčič, Alja; Rener-Primec, Zvonka

doi:10.1177/0883073818787064

Cited by 6 publications

(9 citation statements)

References 22 publications

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“…No study analyzing epileptiform discharge localizations considered the midline-vertex region as a separate region. 8,14,18 Despite the association of midline-vertex discharges with CFS in our study, the presence of midline-vertex discharges do not necessarily predict epilepsy. We noted that similar numbers of patients with midline-vertex discharges on post-CFS EEGs developed and did not develop epilepsy.…”

Section: Discussioncontrasting

confidence: 73%

Exploring the Age-Old Question: What Is the Predictive Value of EEG for Future Epilepsy in Children With Complex Febrile Seizures?

2023

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Children with complex febrile seizures (CFS) have increased risk for the development of epilepsy, but varying prognostic value has been ascribed to abnormal post-CFS electroencephalograms (EEGs). We conducted a retrospective cohort study of 621 children with post-CFS EEGs and identified an association between CFS and midline-vertex discharges, which were present in 52% of the 56 EEGs with interictal epileptiform discharges. Among patients who completed at least 1 year of follow-up, 24.7% subsequently developed epilepsy. Most patients had normal EEGs but 20% had interictal epileptiform discharges. Midline-vertex discharges were seen at a similar rate in children who did not develop epilepsy (55%) and those who developed epilepsy (45%). The development of epilepsy was not associated with any interictal epileptiform discharge localization. Logistic regression modeling identified 4 predictors of future epilepsy: >3 febrile seizures in 24 hours, interictal epileptiform discharges during post-CFS EEG, family history of afebrile seizures, and age of CFS onset ≥ 3 years.

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Section: Discussioncontrasting

confidence: 73%

Exploring the Age-Old Question: What Is the Predictive Value of EEG for Future Epilepsy in Children With Complex Febrile Seizures?

2023

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“…Many studies also revealed that EEG might acquire its predictability for subsequent epilepsy in children with abnormal neurologic or developmental status before FS. [28][29][30] In our study, among 10 patients with SES, 5 had epileptiform discharges over the frontopolar regions. Frontal localization has been described as a positive predictor for subsequent epilepsy by other authors 28,[31][32][33] in patients with FS.…”

Section: Discussionmentioning

confidence: 51%

“…In our study, among 10 patients with SES, 5 had epileptiform discharges over the frontopolar regions. Frontal localization has been described as a positive predictor for subsequent epilepsy by other authors 28 31 32 33 in patients with FS.…”

Section: Discussionmentioning

confidence: 84%

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Clinical Predictive Factors of Pathological EEG in Children with Febrile Seizures and Their Association with Subsequent Epileptic Seizures

Kchaou

Kammoun

Chakroun

et al. 2021

Journal of Pediatric Epilepsy

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The objective of this study was to identify clinical parameters predicting either a pathological EEG or a subsequent epileptic seizure (SES), based on the relation between paroxysmal EEG abnormalities and clinical features in children who presented at least one febrile seizure (FS). We collected data of children who presented to our department during the period 2013 to 2018 for EEG recording as part of their febrile seizure assessment. Only children aged between 1 month to 5 years were included. Both the clinical and EEG data were retrospectively collected and statistically studied. We performed a detailed analysis of the EEG recordings. SES was identified for patients with sufficient follow-up. A total of 120 children were included in the study, of whom 48% had EEG abnormalities. Psychomotor retardation (p = 0.002), completion of an EEG within 7 days of the last FS (p = 0.046), and late age (> 3 years) of the first FS onset (p = 0.021) were significantly associated with a pathological EEG. In multivariate analysis, performing early EEG (< 7 days from the last FS) (odds ratio [OR]: 2.35; p = 0.043; confidence interval [CI]: 1.028–5.375) and psychomotor retardation (OR: 4.19; p = 0.008; CI: 1.46–12) were independent predictors of a pathological EEG. Of 120 patients, 45 had a follow-up. However, only 10 (22.22%) had SES. Children with SES tended more to have a psychomotor delay, compared with children without SES (50% vs. 14.28%, p = 0.029). Moreover, the percentage of initial abnormal EEG in patients with SES was significantly higher than those without SES (70% vs. 34.28%, p = 0.05). Even though some FS characteristics predict EEG abnormalities, they are not always associated with SES. We highlight the importance of performing an EEG in the group of children who had both FS and psychomotor retardation. This is most likely the group at the highest risk of developing epilepsy.

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“…Further, of those individuals who experienced FSs, the frequency of subsequent development of epilepsy was 2.15-fold greater in females, 4.846-fold greater in patients with recurrent FSs ( Chiang et al, 2018 ). Researchers assessed predictive value of epileptiform discharges for subsequent epilepsy after FSs and found that patients with normal EEGs were unlikely to develop epilepsy ( Kavcic and Rener-Primec, 2018 ). The important impact of FSs on subsequent epileptogenesis has been recognized, but over a large time span, it is clinically difficult to validate directly.…”

Section: The Long-term Adverse Outcomes Associated With Fssmentioning

confidence: 99%

The long-term neurodevelopmental outcomes of febrile seizures and underlying mechanisms

You

Chen

2023

Front. Cell Dev. Biol.

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Febrile seizures (FSs) are convulsions caused by a sudden increase in body temperature during a fever. FSs are one of the commonest presentations in young children, occurring in up to 4% of children between the ages of about 6 months and 5 years old. FSs not only endanger children’s health, cause panic and anxiety to families, but also have many adverse consequences. Both clinical and animal studies show that FSs have detrimental effects on neurodevelopment, that cause attention deficit hyperactivity disorder (ADHD), increased susceptibility to epilepsy, hippocampal sclerosis and cognitive decline during adulthood. However, the mechanisms of FSs in developmental abnormalities and disease occurrence during adulthood have not been determined. This article provides an overview of the association of FSs with neurodevelopmental outcomes, outlining both the underlying mechanisms and the possible appropriate clinical biomarkers, from histological changes to cellular molecular mechanisms. The hippocampus is the brain region most significantly altered after FSs, but the motor cortex and subcortical white matter may also be involved in the development disorders induced by FSs. The occurrence of multiple diseases after FSs may share common mechanisms, and the long-term role of inflammation and γ-aminobutyric acid (GABA) system are currently well studied.

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Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures

Cited by 6 publications

References 22 publications

Exploring the Age-Old Question: What Is the Predictive Value of EEG for Future Epilepsy in Children With Complex Febrile Seizures?

Exploring the Age-Old Question: What Is the Predictive Value of EEG for Future Epilepsy in Children With Complex Febrile Seizures?

Clinical Predictive Factors of Pathological EEG in Children with Febrile Seizures and Their Association with Subsequent Epileptic Seizures

The long-term neurodevelopmental outcomes of febrile seizures and underlying mechanisms

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