Short-term neurodevelopmental outcomes of focal febrile seizures

Adachi, Shunichi; Inoue, Masataka; Kawakami, Isao; Koga, Hiroshi

doi:10.1016/j.braindev.2020.01.005

Cited by 4 publications

(5 citation statements)

References 21 publications

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“…The systematic review included 26 studies (Table S1) between 1978 and 2022 5,6,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40 . All reported ≥1 cases within inclusion criteria and data related to our primary mortality outcome (11), or secondary outcomes of neurodevelopment (11) or neuropathology (13).…”

Section: Resultsmentioning

confidence: 99%

“…Among 32 cases of recurrent febrile seizures within 24 h followed for a mean of 28 months, 3% (1/32) had speech delay 21 . Among 263 cases followed for 3 years since febrile seizure onset, cases with neurodevelopmental support services at school were associated with focal febrile seizures and pre‐existing neurodevelopmental abnormalities 18 . Studies evaluating cognitive outcomes also identified pre‐existing neurological deficits associated with febrile seizures.…”

Section: Resultsmentioning

confidence: 99%

“…The systematic review included 26 studies (Table S1) between 1978 and 2022 . 5,6,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40 All reported ≥1 cases within inclusion criteria and data related to our primary mortality outcome (11), or secondary outcomes of neurodevelopment (11) or neuropathology (13). Two studies (Krous et al 5 and Kinney et al 39 ) reported mortality data from the same case registry with undefined case redundancy that could not be clarified after contact with the author.…”

Section: Included Studiesmentioning

confidence: 99%

“…21 Among 263 cases followed for 3 years since febrile seizure onset, cases with neurodevelopmental support services at school were associated with focal febrile seizures and pre-existing neurodevelopmental abnormalities. 18 Studies evaluating cognitive outcomes also identified pre-existing neurological deficits associated with febrile seizures. Among 431 sibling pairs in which one had ≥1 febrile seizure and IQs were normal prior to febrile seizure onset, IQs were similar at 7 years of age.…”

Section: Neurodevelopmentmentioning

confidence: 99%

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Are brief febrile seizures benign? A systematic review and narrative synthesis

Crandall

Delavale

Plovnick³

et al. 2023

Epilepsia

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Febrile seizures affect 2%–5% of U.S. children and are considered benign although associated with an increased risk of epilepsy and, rarely, with sudden unexplained death. We compared rates of mortality, neurodevelopmental disorders, and neuropathology in young children with simple and complex febrile seizures to healthy controls. We systematically reviewed studies of 3‐ to 72‐month‐old children with simple or complex febrile seizures ≤30 min. We searched studies with outcome measures on mortality, neurodevelopment, or neuropathology through July 18, 2022. Bias risk was assessed per study design. Each outcome measure was stratified by study design. PROSPERO registration is CRD42022361645. Twenty‐six studies met criteria reporting mortality (11), neurodevelopment (11), and neuropathology (13), including 2665 children with febrile seizures and 1206 seizure‐free controls. Study designs varied: 15 cohort, 2 cross‐sectional, 3 case–control, 5 series, and 1 case report. Mortality outcomes showed stark contrasts. Six cohort studies following children after febrile seizure (n = 1348) reported no deaths, whereas four child death series and 1 case report identified 24.1% (108/449) deaths associated with simple (n = 104) and complex (n = 3) febrile seizures ≤30 min. Minor hippocampal histopathological anomalies were common in sudden deaths with or without febrile seizure history. Most electroencephalography (EEG) studies were normal. Neuroimaging studies suggested increased right hippocampal volumes. When present, neurodevelopmental problems usually preexisted febrile‐seizure onset. Risk bias was medium or high in 95% (18/19) of cohort and case–control studies vs medium to low across remaining study designs. Research on outcomes after simple or brief complex febrile seizures is limited. Cohort studies suffered from inadequate sample size, bias risk, and limited follow‐up durations to make valid conclusions on mortality, neurodevelopment, and neuropathology. Sudden death registries, focused on a very small percentage of all cases, strongly suggest that simple febrile seizures are associated with increased mortality. Although most children with febrile seizures have favorable outcomes, longer‐term prospective studies are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Neurodevelopmentmentioning

confidence: 99%

See 2 more Smart Citations

Are brief febrile seizures benign? A systematic review and narrative synthesis

Crandall

Delavale

Plovnick³

et al. 2023

Epilepsia

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“…El riesgo de desarrollar epilepsia posterior a convulsión febril no es significativamente alto comparado con la población general, no obstante hay mayor riesgo en aquellos pacientes que tienen: convulsiones febriles y neurodesarrollo anormal, convulsiones febriles focales, múltiples y prolongadas, antecedente heredofamiliar de epilepsia, primer convulsión febril en mayores de tres años, trastorno del espectro autista o aquellos que convulsionaron durante la primer hora del episodio febril. El uso de medicamentos anticonvulsivantes no ha demostrado tener efectos beneficiosos para prevenir el desarrollo de epilepsia (21,22,23).…”

Section: Pronósticounclassified

Abordaje de las convulsiones febriles en la infancia.

Cabezas¹,

Solís.

2022

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Las convulsiones febriles suelen suceder en niños (as) entre los 6 meses y 5 años de edad asociado a altas temperaturas corporales y en ausencia de un proceso infeccioso en sistema nervioso central o epilepsia. La etiología es multifactorial e incluye factores de riesgo como enfermedades virales, ciertas vacunas o predisposición genética. De acuerdo a las características, se clasifican en simples y complejas. Las convulsiones febriles simples no requieren más estudios de laboratorio, neuroimagen o tratamiento farmacológico, mientras que las convulsiones complejas pueden requerir más estudios, sin embargo, normalmente no van a requerir profilaxis farmacológica para prevenir una crisis. Las convulsiones febriles generalmente no afectan el desarrollo neurológico ni aumentan el riesgo de epilepsia. Es importante ya que estos episodios generan mucha ansiedad en padres y cuidadores, por lo que todo personal de salud debe brindar educación adecuada sobre el manejo de futuras crisis y pronóstico de estos eventos.

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