Age of presentation of febrile seizures and family history in children

Abstract

The aims of the study were: (1) to determine the age of onset of febrile seizures in children with and without a family history of seizures, and (2) to identify the aetiology of febrile seizures. Patients and Methods: A prospective descriptive observational study was carried out at the Department of Paediatric Medicine, The Children's Hospital and The Institute of Child Health in Lahore, Pakistan, from August 2010 to March 2012. A total of 180 patients aged 3 months to 5 years were enrolled in the study. The data of all children with febrile seizures was recorded on special proforma which included history (demographic data, presenting complaints, duration of illness, developmental and birth history, and family history of febrile seizures and epilepsy), complete clinical examination (vital signs, head circumference and neurological examination) and laboratory investigations (complete blood count including total and differential leukocyte counts, serum electrolytes, erythrocyte sedimentation rate, urine analysis, and chest X-ray where needed). Seizures were considered as febrile by excluding infections of the central nervous system on the basis of history, examination and relevant laboratory investigations. Treatment was given in the form of anticonvulsants, antipyretics and antibiotics. Results: Among 180 children, 54% were male and 46% were female. Age distribution was as follows: 82 (45.6%) children below one year of age, 38 (21.1%) aged 1-2 years, 30 (16.7%) aged 2-3 years, 18 (10%) aged 3-4 years and 12 (6.6 %) aged 4-5 years. Febrile seizures were simple in 74% and complex in 26% of cases. The average age of onset of febrile seizures in children with positive family history was 11.4 months. Regarding aetiology of febrile seizures, majority of the children (37.2%) had upper respiratory tract infections, followed by acute watery diarrhoea (17.2%), bronchopneumonia (8.3%) and others, whereas in 26.1% cases, no source of infection was found. Conclusion: In children with a positive family history of seizures, the age of onset of febrile seizures is earlier as compared to children where such history is not present. Thus, family history is an important risk factor for febrile seizures.

Keywords: Family history, Febrile seizures, Upper respiratory tract infections