Utility of initial EEG in first complex febrile seizure

Harini, Chellamani; Nagarajan, Elanagan; Kimia, Amir A.; Carvalho, Rachel Marin; An, Sookee; Bergin, Ann M.; Takeoka, Masanori; Pearl, Phillip L.; Loddenkemper, Tobias

doi:10.1016/j.yebeh.2015.09.003

Cited by 26 publications

(33 citation statements)

References 24 publications

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“…14,17,21 In our complex febrile seizure group, 3 of 20 (15%) patients with epileptiform discharges had subsequent epileptic seizures, which is the same percentage as in Harini's study. 17 The overall percentage of patients with complex febrile seizures and subsequent epileptic seizures in our study was low (4%) compared to approximately 10% in similar studies. 14,17 Many confounders could have influenced our results because of the retrospective nature of the study, the most important being possible drop out of some patients with complex febrile seizures.…”

Section: Discussionsupporting

confidence: 76%

“…However, the positive predictive value of epileptiform discharges after complex febrile seizures is comparable to the results of other studies. 17 The number of febrile seizures has been suggested as one of the risk factors for associated epileptiform activity by some authors. 12 In our study, the highest positive predictive value of epileptiform discharges was indeed calculated in the group with recurrent febrile seizures (38.5%).…”

Section: Discussionmentioning

confidence: 99%

“…20 The outcome was evaluated in 2017, that is, 3 to 8 years after the first assessment for febrile seizure (mean 4.1 + 1.3, median 4), which is comparable to other studies. 17,21 A diagnosis of epilepsy at followup was defined as the occurrence of at least 2 episodes of unprovoked seizures more than 24 hours apart. An epileptic seizure was defined as a single unprovoked seizure in the afebrile state.…”

Section: Methodsmentioning

confidence: 99%

“…According to some authors, 13,14 EEG should be obtained in every patient after a complex febrile seizure. Others [15][16][17] reported a low predictive value of paroxysmal discharges on the EEG in otherwise neurologically normal children with febrile seizures and suggested that the practice parameters regarding simple febrile seizure can be extended to neurologically normal children with any type of febrile seizures.…”

mentioning

confidence: 99%

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Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures

Kavčič

Rener-Primec

2018

J Child Neurol

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The predictive value of epileptiform discharges for subsequent epilepsy after febrile seizures was studied in 140 children: 72 children (51%) had simple febrile seizures and 68 children (49%) had complex febrile seizures. Electroencephalography (EEG) was performed in 103 children (74%), it was normal in 66 (47%) and with epileptiform patterns in 37 patients (26%). At follow-up in 2017, 10 children developed epilepsy, 1 had a single epileptic seizure, 9 of them had epileptiform EEGs. Of the patients with normal EEGs after complex febrile seizures, none developed epilepsy, and 92% of patients with normal EEGs after recurrent febrile seizures did not develop epilepsy. Therefore, patients with normal EEGs were unlikely to develop epilepsy. Fifteen percent of patients with complex and 31% of patients with recurrent febrile seizures and epileptiform EEGs developed epileptic seizures. The positive predictive value of epileptiform discharges was low in complex and twice as high in recurrent febrile seizures.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures

Kavčič

Rener-Primec

2018

J Child Neurol

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“…Thus, early EEG abnormalities after a first complex FS are unlikely to identify patients at risk of epilepsy. There are likely to be multiple factors that influence the occurrence of EEG abnormalities, such as the age of the patient, the timing of the EEG, and genetic syndromes [ 29 ]. Repetition of this test is not necessary in children who present with recurrent episodes of simple FS and have a clear source of infection, but it is important to accurately determine the cause of the infection and to manage it in the most appropriate way [ 19 ].…”

Section: Diagnosismentioning

confidence: 99%

Management of Pediatric Febrile Seizures

Laino

Mencaroni

Esposito

2018

IJERPH

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Febrile seizures (FS), events associated with a fever in the absence of an intracranial infection, hypoglycaemia, or an acute electrolyte imbalance, occur in children between six months and six years of age. FS are the most common type of convulsions in children. FS can be extremely frightening for parents, even if they are generally harmless for children, making it important to address parental anxiety in the most sensitive manner. The aim of this review was to focus on the management of FS in the pediatric age. An analysis of the literature showed that most children with FS have an excellent prognosis, and few develop long-term health problems. The diagnosis of FS is clinical, and it is important to exclude intracranial infections, in particular after a complex FS. Management consists of symptom control and treating the cause of the fever. Parents and caregivers are often distressed and frightened after a FS occurs and need to be appropriately informed and guided on the management of their child’s fever by healthcare professionals. Due to the inappropriate use of diagnostic tests and treatments, it is extremely important to improve the knowledge of pediatricians and neurologists on FS management and to standardize the diagnostic and therapeutic work-up.

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Febrile Seizures

Quvile¹,

Wilmshurst²

2020

Clinical Child Neurology

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Utility of initial EEG in first complex febrile seizure

Cited by 26 publications

References 24 publications

Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures

Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures

Management of Pediatric Febrile Seizures

Febrile Seizures

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