Abstract:

Objective: The approach, diagnostic investigations, follow-up, and treatment in children presented with febrile seizures are still controversial. We aimed to determine the clinical characteristics, laboratory results, electroencephalography and neuroimaging findings, treatment modalities, and outcome at 1-year-long follow-up period in children presented with febrile seizures. Methods: A total of 269 children (109 females and 160 males) between the ages of 3 and 60 months who were referred to pediatric neurology department due to febrile seizures between July, 2011 and November, 2013 were enrolled into the study. Results: Mean ages at onset of the febrile seizures and at admission were 20.1±12.1 months and 29.2±15.3 months, respectively. A total of 154 (57.2%) patients had recurrent febrile seizures; 2 seizures in 80 (29.7%), 3 in 49 (18.2), and >3 in 25 (9.3%) patients. A history of febrile seizures and epilepsy among the first-degree relatives was obtained in 55(20.8%) and 37 (14.0%) patients, respectively. Six (2.2%) patients presented with febrile status epilepticus. Electroencephalography was performed in 180 (63.6%) patients, and revealed epileptic discharges in 18 (10%) children. Brain magnetic resonance imaging studies were carried out in 40 (14.9%) patients, of them, 6 (15.0%) had incidental nonspecific white matter lesions which were all irrelevant to seizures. Forty one (30.6%) patients were found to have anemia. Antiepileptic medication was initiated in 26 (9.7%) patients (phenobarbital in 8 and valproate in 18 patients); rectal diazepam was prescribed in the remaining 243 (90.3%) patients. The seizures were simple in 182 (67.7%) and complicated in the remaining 87 (32.3%) patients. At the end of 1-year of follow-up period, a diagnosis of epilepsy was made in 5 (4%) of 124 children who had all complicated and recurrent febrile seizures. Conclusion: Electroencephalography should be performed in children presented with complicated seizures, and patients those with epileptic discharges on electroencephalography should be given a close follow-up in regard to epilepsy development. The yield of neuroimaging is not contributory to the diagnostic and therapeutic approach.

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