Risk of Epilepsy in Children Presenting to Emergency Departments with Their First Afebrile Seizure: A Retrospective Multicenter Study

Abstract

Seizure is one of the most common neurologic disorders in pediatric emergency department visits. Early detection of epilepsy development in children with afebrile seizures is important. We identified predictors of epilepsy development in children with their first afebrile seizure. In this retrospective multicenter study, we enrolled pediatric patients aged 1 month to 18 years who presented with afebrile seizures at the emergency department from January 2017 to December 2020. Multivariable logistic regression analysis was performed to identify factors associated with epilepsy development. A total of 417 pediatric patients were enrolled, 161 (38.6%) of whom developed epilepsy. From the multivariable logistic regression analysis, older age at onset (2–5 years, odds ratio [OR] 2.611, p = 0.010; 11–15 years, OR 3.138, p = 0.003; 16–18 years, OR 4.292, p = 0.002), longer seizure duration of more than 10 min (OR 4.869, p = 0.006), two or more seizures (OR 2.378, p = 0.004), lethargy (OR 2.341, p = 0.021), and a lactate level > 2.27 mg/dL (OR 4.205, p < 0.001) were significant predictors for the development of epilepsy in children experiencing their first afebrile seizure.

Risk of seizure recurrence in children with new-onset afebrile seizure

“…Consistent with the findings of Maia et al, 6 we found a 12.7% incidence of first afebrile seizures in patients aged 11-15 years. Furthermore, the recurrence of seizures was significantly higher in patients over 11 years than in those under 5 (RR = 1.316), which is in line with the findings of Woo et al 7 Consistent with previous studies, 8,9 we also found that sex was not associated with recurrence following the first nonfebrile seizure. Studies investigating the risk factors associated with unprovoked seizure recurrence in children have reported recurrence rates of 27-50%, [10][11][12] consistent with our present findings (45.3%).…”