Drgawki gorączkowe – Epidemiologia

Drgawki gorączkowe
Epidemiologia

Drgawki gorączkowe (febrile seizures) są najczęstszym zaburzeniem neurologicznym wieku dziecięcego, występującym u dzieci między 6. miesiącem a 5. rokiem życia, z częstością 2-5% w populacjach USA i Europy Zachodniej, a szczytem zachorowań między 12 a 18 miesiącem życia. Występują w kontekście gorączki bez objawów zakażenia OUN i wykazują znaczne zróżnicowanie geograficzne (np. 6-9% w Japonii, 14% na wyspie Guam, 0,35% w Hongkongu). Czynniki ryzyka obejmują płeć męską (proporcja 1,6:1), obciążony wywiad rodzinny, dysfunkcje neurologiczne, uczęszczanie do żłobka (zwiększające ryzyko 19,35-krotnie) oraz genetyczne predyspozycje (powiązania z chromosomem 2q i genami kanałów sodowych). Około 30-40% dzieci doświadcza nawrotów, a ryzyko wzrasta przy obecności czynników takich jak wiek <18 miesięcy, temperatura <40,0°C przy pierwszym napadzie oraz krótki czas (<1 godz.) między gorączką a drgawkami. Rokowanie jest dobre, z ryzykiem rozwoju padaczki po prostych drgawkach na poziomie 1-2%, a po złożonych 4-15%.

Epidemiologia drgawek gorączkowych

Występowanie geograficzne
Sezonowość występowania
Czynniki ryzyka i predyspozycje
Nawroty i rokowanie
Związek z infekcjami i szczepieniami
Wpływ pandemii COVID-19
Metody nadzoru i monitorowania
Klasyfikacja i obciążenie systemów opieki zdrowotnej
Kolejne rozdziały

Epidemiologia drgawek gorączkowych

Drgawki gorączkowe (ang. febrile seizures) stanowią najczęstsze zaburzenie neurologiczne wieku dziecięcego, dotyczące dzieci pomiędzy 6. miesiącem a 5. rokiem życia. Częstość występowania drgawek gorączkowych wynosi 2-5% wśród dzieci w Stanach Zjednoczonych i Europie Zachodniej¹²³. Szczyt zachorowań przypada na wiek między 12 a 18 miesiącem życia⁴⁵. Charakterystyczną cechą drgawek gorączkowych jest ich związek z występowaniem gorączki, bez objawów zakażenia ośrodkowego układu nerwowego czy innej zdefiniowanej przyczyny⁶.

Występowanie geograficzne

Częstość występowania drgawek gorączkowych wykazuje znaczne zróżnicowanie geograficzne. Podczas gdy w krajach zachodnich częstość ta wynosi 2-5%, to w Japonii obserwuje się wskaźnik 6-9%, w Indiach 5-10%, na wyspie Guam 14%, w Hongkongu 0,35%, a w Chinach 0,5-1,5%⁷⁸. Te różnice mogą wynikać z czynników genetycznych, geograficznych oraz środowiskowych⁹.

W badaniach prowadzonych w Iranie zbiorczy wskaźnik chorobowości drgawek gorączkowych wśród innych napadów drgawkowych u dzieci wynosił 47,9% (95% CI 38,8-59,9%), z istotnymi różnicami geograficznymi: w centralnej części kraju – 40,03% (95% CI: 37,09%-42,07%), na wschodzie – 59,4% (95% CI: 38,2%-80,7%), na południu – 44,1% (95% CI: 37,4%-50,8%), a na zachodzie – 57,5% (95% CI: 49,1%-65,9%). Najniższy wskaźnik odnotowano na północy kraju – 33,0% (95% CI: 24,5%-41,5%)¹⁰.

W Turcji badania wykazały częstość występowania drgawek gorączkowych na poziomie 2,57% w prowincji Eskisehir¹¹, a w Izmirze 4,8%¹², co jest wartością niższą niż w poprzednich badaniach prowadzonych w tym regionie (9,7-12,8%). Różnice te mogą wynikać z rozwoju systemów opieki zdrowotnej oraz zwiększenia świadomości rodziców dotyczącej gorączki u dzieci¹³.

W Brazylii badanie populacyjne przeprowadzone w mieście Barra do Bugres wykazało częstość występowania drgawek gorączkowych na poziomie 6,4/1000 mieszkańców (95% CI: 3,8-10,1), co jest wartością niższą niż w innych regionach Brazylii (13,9-16,0/1000)¹⁴¹⁵.

W Korei badania z wykorzystaniem dużych zbiorów danych wykazały, że roczna częstość występowania drgawek gorączkowych określona na podstawie wskaźnika wizyt szpitalnych wynosiła 1,4%, z przewagą u chłopców (1,5%) nad dziewczynkami (1,2%) w wieku poniżej 5 lat. Szczyt częstości występowania przypadał na trzeci rok życia (2,2%)¹⁶.

Sezonowość występowania

Zaobserwowano sezonowy i dobowy związek drgawek gorączkowych w Japonii, Finlandii i USA, z większą liczbą epizodów występujących po południu i w miesiącach zimowych¹⁷. Badanie przeprowadzone we Włoszech na grupie 188 pierwszych przypadków drgawek gorączkowych wykazało znaczący wzrost ich występowania między godziną 18:00 a 23:59 oraz szczyt sezonowy w styczniu¹⁸.

Badanie ekologiczne wykazało 1,75-2,06-krotny roczny współczynnik ryzyka wystąpienia drgawek gorączkowych w okresie czerwiec-wrzesień, statystycznie potwierdzając rozpoznawalny zimowy szczyt zachorowań oraz przypisując sezonowy związek kilku infekcjom wirusowym, w tym nowatorskie powiązanie z ludzkim metapneumowirusem¹⁹.

W Korei miesięczna częstość występowania pokazała wyższe ryzyko drgawek gorączkowych w okresie od kwietnia do lipca, wynoszące 42,3% (test Manna-Whitneya, P=0,0001)²⁰.

Czynniki ryzyka i predyspozycje

Drgawki gorączkowe występują częściej u chłopców niż u dziewczynek, z proporcją 1,6:1²¹²². Badanie prowadzone w Danii potwierdziło, że drgawki gorączkowe były częstsze u chłopców niż u dziewcząt (21% różnicy względnego ryzyka)²³.

Do czynników statystycznie skorelowanych z drgawkami gorączkowymi należą: obciążony wywiad rodzinny, objawy dysfunkcji neurologicznej lub niepełnosprawności rozwojowej, opóźnione wypisanie noworodka ze szpitala oraz uczęszczanie do żłobka²⁴. W badaniu przeprowadzonym w Turcji wykazano, że uczęszczanie do żłobka zwiększa ryzyko drgawek gorączkowych 19,35 razy, obciążony wywiad rodzinny – 7,52 razy, a pokrewieństwo rodziców – 13,1 razy²⁵.

Dominująca hipoteza etiopatogenetyczna sugeruje, że drgawki gorączkowe mają wyraźną predyspozycję genetyczną. Jeśli dziecko doświadcza drgawek gorączkowych, ryzyko, że jego rodzeństwo również ich doświadczy, waha się od 10 do 45%. Bliźnięta jednojajowe wykazują wyższe wskaźniki zgodności drgawek gorączkowych w porównaniu z bliźniętami dwujajowymi (53% wobec 18%)²⁶.

Badania linkage donoszą o powiązaniach na wielu chromosomach, takich jak 2q, 5q, 8q, 19p i 19q, z najsilniejszym powiązaniem na chromosomie 2q, a konkretnie z genami odpowiedzialnymi za receptory kanałów sodowych²⁷.

Nawroty i rokowanie

Około 30-40% dzieci, które doświadczyły pierwszego epizodu drgawek gorączkowych, będzie miało nawroty w okresie wczesnego dzieciństwa²⁸²⁹. Według innych źródeł, skumulowane ryzyko nawrotu drgawek gorączkowych po pierwszym napadzie wynosi 22,7%, bez różnicy między chłopcami a dziewczynkami. Ryzyko nawrotu wzrasta z każdym kolejnym prostym napadem drgawek gorączkowych: 35,6% szans na nawrót po drugim napadzie i 43,5% po trzecim³⁰.

Do czynników ryzyka nawrotu należą: obciążony wywiad rodzinny w kierunku drgawek gorączkowych, wiek poniżej 18 miesięcy, temperatura niższa niż 40,0°C przy pierwszych drgawkach oraz czas krótszy niż 1 godzina między początkiem choroby gorączkowej a pierwszymi drgawkami³¹. Liczba czynników ryzyka jest wprost proporcjonalna do ryzyka nawrotu. Dziecko z dwoma lub więcej czynnikami ryzyka ma ponad 30% ryzyko nawrotu w wieku 2 lat, a ryzyko to podwaja się przy trzech czynnikach ryzyka³².

Ogólnie drgawki gorączkowe mają dobre rokowanie. Ryzyko rozwoju padaczki po prostym napadzie drgawek gorączkowych wynosi 1-2%, co jest wyższe niż w populacji ogólnej, ale klinicznie nieistotne³³³⁴. Natomiast złożone drgawki gorączkowe wiążą się z rozwojem padaczki w 4-15% przypadków, w zależności od liczby cech złożonych³⁵.

Związek z infekcjami i szczepieniami

Infekcje wirusowe są dobrze opisanymi dominującymi czynnikami wywołującymi drgawki gorączkowe, wykrywanymi u nawet 82% dzieci z drgawkami gorączkowymi³⁶. Najczęstsze infekcje związane z drgawkami gorączkowymi u dzieci to ospa wietrzna, grypa, infekcje ucha środkowego, infekcje górnych i dolnych dróg oddechowych (takie jak zapalenie migdałków, zapalenie płuc, zapalenie oskrzeli i zapalenie zatok), infekcje zębów oraz zapalenie żołądka i jelit (szczególnie wywołane przez rotawirusy)³⁷.

W badaniu prowadzonym w Kanadzie w okresie pandemii COVID-19 (sierpień 2021 – grudzień 2022) spośród 3367 przypadków drgawek gorączkowych, 649 (19%) zostało hospitalizowanych, 156 (5%) miało potwierdzoną laboratoryjnie ostrą infekcję SARS-CoV-2, 363 (11%) miało infekcję inną niż SARS-CoV-2, a 107 (3%) wystąpiło jako niepożądane zdarzenia po szczepieniu (szczepieni w ciągu 15 dni przed wystąpieniem)³⁸. Drgawki gorączkowe były częściej związane z infekcją niż ze szczepieniem³⁹.

Pewne szczepionki, w tym szczepionki zawierające antygen odry oraz niektóre szczepionki przeciw grypie, są związane ze zwiększonym ryzykiem drgawek gorączkowych⁴⁰. Kilka badań dotyczących dzieci w Stanach Zjednoczonych analizowało, czy szczepienie przeciw grypie jest związane ze zwiększonym ryzykiem drgawek gorączkowych. Chociaż w niektórych sezonach grypowych wykryto nieznacznie zwiększone ryzyko drgawek gorączkowych u małych dzieci po szczepionce przeciw grypie, dotyczyło to głównie dzieci w wieku 12-23 miesięcy, szczególnie gdy szczepionka przeciw grypie była podawana jednocześnie ze szczepionką przeciw pneumokokom (PCV13) i szczepionką zawierającą komponenty błonicy, tężca i krztuśca (DTaP)⁴¹.

Po szczegółowym przeglądzie danych dotyczących drgawek gorączkowych i rozważeniu korzyści płynących ze szczepienia dzieci przeciwko tym chorobom, CDC zdecydowało, że nie należy wprowadzać żadnych zmian w zaleceniach dotyczących szczepień dzieci⁴². Drgawki gorączkowe nie są powodem do unikania szczepień. Szczepienia pomagają zapobiegać infekcjom wywołanym przez powszechne wirusy lub bakterie, które mogą wywoływać drgawki gorączkowe, ostatecznie zmniejszając ogólne ryzyko⁴³.

Wpływ pandemii COVID-19

Podczas pandemii COVID-19 w Kanadzie ryzyko drgawek gorączkowych nadal osiągało szczyt w drugim roku życia i wykazywało niewielką przewagę u płci męskiej. Tylko 13,9% hospitalizowanych przypadków drgawek gorączkowych miało pozytywny wynik testu na infekcję SARS-CoV-2, pomimo wysokiej transmisji SARS-CoV-2 w społeczności⁴⁴.

Badanie wykazało ogólny spadek częstości występowania drgawek gorączkowych podczas pandemii koronawirusa w porównaniu z okresem przed pandemią. Zaobserwowano znaczne zmniejszenie częstości występowania infekcji wirusem grypy (p<0,001) podczas pandemii, podczas gdy częstość występowania infekcji rinowirusem nie zmieniła się znacząco (p=0,811). Co ciekawe, zaobserwowano znacznie wyższą częstość występowania infekcji wirusem paragrypy (p=0,001) podczas pandemii⁴⁵.

Nie zaobserwowano statystycznie istotnych różnic między grupami w prezentacji klinicznej i wynikach drgawek gorączkowych przed i w trakcie pandemii⁴⁶.

Metody nadzoru i monitorowania

W celu monitorowania drgawek gorączkowych i ich związku ze szczepieniami prowadzone są różne programy nadzoru. Przykładem jest kanadyjski program IMPACT (Canadian Immunization Monitoring Program Active), który prowadził aktywny nadzór nad hospitalizacjami z powodu chorób, którym można zapobiegać poprzez szczepienia, oraz nad wybranymi niepożądanymi oddziaływaniami po szczepieniu (AEFIs), w tym drgawkami gorączkowymi, w pediatrycznych ośrodkach opieki trzeciorzędowej w latach 1991-2023⁴⁷.

W Australii program PAEDS (Paediatric Active Enhanced Disease Surveillance) przeprowadził badanie w okresie od maja 2013 do czerwca 2014 r., zbierając szczegółowe informacje kliniczne i epidemiologiczne na temat wszystkich przypadków drgawek gorączkowych w 5 ośrodkach PAEDS. Dane te wykorzystano do określenia ryzyka drgawek gorączkowych po wprowadzeniu nowych szczepionek do Narodowego Programu Szczepień i porównania wyników klinicznych dzieci, które doświadczyły drgawek gorączkowych po szczepieniu, z dziećmi, które doświadczyły drgawek gorączkowych niezwiązanych ze szczepieniem⁴⁸.

Niedawne innowacje w molekularnej diagnostyce wirusów układu oddechowego pozwalają na jednoczesne testowanie wielu wirusów przy użyciu multipleksowej reakcji łańcuchowej polimerazy (PCR). W badaniu przeprowadzonym w południowo-wschodnim Melbourne analizowano czasowe związki między epidemiologią organizmów a wynikami zdrowotnymi. Ustanowiono metodę badania czasowych związków wirusów z chorobą poprzez wykorzystanie niezależnych zbiorów danych⁴⁹.

Możliwość oszacowania przypisywalnej proporcji dla poszczególnych wirusów w przypadku stanów takich jak drgawki gorączkowe stwarza potencjał do informowania o obciążeniu chorobą związanym z organizmem i wynikających z tego ocen technologii zdrowotnych dla szczepionek przeciwwirusowych i terapeutyków⁵⁰.

Klasyfikacja i obciążenie systemów opieki zdrowotnej

Drgawki gorączkowe są klasyfikowane jako proste drgawki gorączkowe, obejmujące pojedynczy napad trwający 15 minut lub krócej, lub złożone drgawki gorączkowe, charakteryzujące się wieloma napadami występującymi w ciągu 24 godzin z ogniskowymi cechami neurologicznymi lub napadem trwającym 15 minut lub dłużej⁵¹. Proste drgawki gorączkowe stanowią większość przypadków. Gorączkowy stan padaczkowy odnosi się do napadów trwających dłużej niż 30 minut i jest rzadkim podtypem drgawek gorączkowych związanym z gorszymi wynikami niż proste drgawki gorączkowe⁵².

Około 65-70% drgawek gorączkowych to proste drgawki gorączkowe, 20-35% to złożone drgawki gorączkowe, a około 5% to gorączkowy stan padaczkowy⁵³. Około 80% przypadków drgawek gorączkowych występuje z infekcją wirusową⁵⁴.

Drgawki gorączkowe stanowią 1-2% wszystkich wizyt na oddziałach ratunkowych rocznie⁵⁵. Ocena drgawek gorączkowych polega głównie na scharakteryzowaniu typu drgawek gorączkowych pacjenta i określeniu podstawowej przyczyny gorączki poprzez ocenę kliniczną i badania diagnostyczne⁵⁶.

Większość drgawek gorączkowych ustępuje samoistnie i dlatego może być leczona wyczekująco. Jednak złożone lub dłużej trwające drgawki gorączkowe mogą wymagać terapii farmakologicznej w celu zatrzymania aktywności napadowej⁵⁷.

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Materiały źródłowe

#1 Febrile Seizures: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/801500-overview
Between 2% and 5% of children have febrile seizures by their fifth birthday. […] A similar rate of febrile seizures is found in Western Europe. The incidence elsewhere in the world varies between 5% and 10% for India, 8.8% for Japan, 14% for Guam, 0.35% for Hong Kong, and 0.5-1.5% for China. […] Febrile seizures occur in all races. […] Some studies demonstrate a slight male predominance. […] By definition, febrile seizures occur in children aged 3 months to 5 years. The highest incidence of febrile seizures has been reported in children aged 12-18 months.
#2 Clinical features and evaluation of febrile seizures – UpToDate
https://www.uptodate.com/contents/clinical-features-and-evaluation-of-febrile-seizures%3Fsource%3Dhistory_widget
Febrile seizures are the most common neurologic disorder of infants and young children. They are an age-dependent phenomenon, occurring in 2 to 4 percent of children younger than five years of age. […] The risk factors, clinical features, and diagnostic evaluation of febrile seizures are reviewed here. […] A febrile seizure refers to an event in infancy or childhood, usually occurring between six months and five years of age, associated with fever but without evidence of intracranial infection or defined cause.
#3 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are the most common type of seizure in children between the ages of 6 months to 5 years. Febrile seizures are the most common type of seizures in childhood, with a slight male predominance of 1.6:1. Febrile seizures have an incidence of 2% to 5% of US and European children, which peaks between 12 to 18 months of age. A seasonal and diurnal association has also been observed in Japan, Finland, and the US, with more episodes occurring in the afternoon and winter months. Some children have a single febrile seizure event, while 30% of children have multiple seizures during early childhood. […] The evaluation of febrile seizures primarily consists of characterizing a patient’s type of febrile seizure and determining the fever’s underlying cause through clinical assessment and diagnostic studies. Most febrile seizures spontaneously resolve and, therefore, may be expectantly managed. However, complex or longer-lasting febrile seizures may require pharmacologic therapy to stop the seizure activity.
#4 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are the most common type of seizure in children between the ages of 6 months to 5 years. Febrile seizures are the most common type of seizures in childhood, with a slight male predominance of 1.6:1. Febrile seizures have an incidence of 2% to 5% of US and European children, which peaks between 12 to 18 months of age. A seasonal and diurnal association has also been observed in Japan, Finland, and the US, with more episodes occurring in the afternoon and winter months. Some children have a single febrile seizure event, while 30% of children have multiple seizures during early childhood. […] The evaluation of febrile seizures primarily consists of characterizing a patient’s type of febrile seizure and determining the fever’s underlying cause through clinical assessment and diagnostic studies. Most febrile seizures spontaneously resolve and, therefore, may be expectantly managed. However, complex or longer-lasting febrile seizures may require pharmacologic therapy to stop the seizure activity.
#5 Febrile Seizures Following Childhood Vaccinations, Including Influenza Vaccination | Influenza (Flu) | CDC
https://www.cdc.gov/flu/vaccine-safety/febrile.html
Most febrile seizures happen in children between the ages of 6 and 59 months. Up to 5% of young children will have at least one febrile seizure. The most common age range for children to have febrile seizures is 14-18 months. […] About 1 in 3 children who have one febrile seizure will have more febrile seizures during childhood. If a member of a child’s immediate family (a brother, sister, or parent) has had febrile seizures, that child is more likely to have a febrile seizure. […] Febrile seizures can be frightening, but nearly all children who have a febrile seizure recover quickly, are healthy afterwards, and do not have any permanent neurological damage. Febrile seizures do not make children more likely to develop epilepsy or any other seizure disorder. […] Vaccines can cause fevers, but febrile seizures are rare after vaccination. Importantly, getting sick with the flu also can cause febrile seizures.
#6 Clinical features and evaluation of febrile seizures – UpToDate
https://www.uptodate.com/contents/clinical-features-and-evaluation-of-febrile-seizures%3Fsource%3Dhistory_widget
Febrile seizures are the most common neurologic disorder of infants and young children. They are an age-dependent phenomenon, occurring in 2 to 4 percent of children younger than five years of age. […] The risk factors, clinical features, and diagnostic evaluation of febrile seizures are reviewed here. […] A febrile seizure refers to an event in infancy or childhood, usually occurring between six months and five years of age, associated with fever but without evidence of intracranial infection or defined cause.
#7 Febrile Seizures: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/801500-overview
Between 2% and 5% of children have febrile seizures by their fifth birthday. […] A similar rate of febrile seizures is found in Western Europe. The incidence elsewhere in the world varies between 5% and 10% for India, 8.8% for Japan, 14% for Guam, 0.35% for Hong Kong, and 0.5-1.5% for China. […] Febrile seizures occur in all races. […] Some studies demonstrate a slight male predominance. […] By definition, febrile seizures occur in children aged 3 months to 5 years. The highest incidence of febrile seizures has been reported in children aged 12-18 months.
#8 Management of Pediatric Febrile Seizures
https://www.mdpi.com/1660-4601/15/10/2232
Febrile seizures (FS) are seizures or convulsions that occur in children between six months and six years of age and are triggered by fever. FS are the most common type of convulsions in children. Their prevalence is approximately 3%â4% in white children, 6%â9% in Japanese children, and 5%â10% in Indian children. […] FS have a prevalence of 2%â5% in children in Western Europe and the United States, and the peak age of onset is 18 months. Children aged 12â30 months represent 50% of all children with FS, while the proportion of children who experience a first episode of FS after four years of age is low (6%â15%). Children of all ethnic groups may present with FS, but there is a higher prevalence in some ethnic groups, in particular Guamanians (14%), Japanese (6%â9%), and Indians (5%â10%). […] The exact causes of FS are still unknown, although some studies indicate a possible association with environmental and genetic factors.
#9 Prevalence of Febrile Seizures in School-Aged Children: A Community Based Survey in Ä°zmir, Turkey – The Journal of Pediatric Research
https://jpedres.org/articles/prevalence-of-febrile-seizures-in-school-aged-children-a-community-based-survey-in-izmir-turkey/doi/jpr.29290
The FS prevalence determined in our study is lower than previous studies in Turkey. It was thought that the advancing healthcare systems in our country might have decreased the FS prevalence within the last eight years in Izmir. […] The prevalence of FS varies in different parts of the world. These differences are thought to be due to genetic, geographic and environmental factors. However, there has been no recent study about the prevalence of FS among Turkish children. This study was designed to find out the prevalence, clinical and some epidemiological features of FS among Turkish school children. […] The prevalence of FS in Turkey was found to be between 3.5% and 12.8% in previous studies. These differences are thought to be due to genetic, geographic and environmental factors. Also, due to socio-economic and environmental factors of population change through time, the prevalence of FS might have changed.
#10 Febrile Seizures: Etiology, Prevalence, and Geographical Variation
https://pmc.ncbi.nlm.nih.gov/articles/PMC4135278/
Febrile seizures (FSs) are the most common neurological disorder observed in the pediatric age group. The present study provides information about epidemiological and clinical characteristics as well as risk factors associated with FS among Iranian children. […] Many studies have already revealed etiology, prevalence, and geographical variation of apparent FSs among Iranian children across the country. […] The pooled prevalence rate of childhood febrile seizure compared to other childhood seizures in Iran was 47.9% (95% CI 12.3-29.5%). […] A significant geographic discrepancy on prevalence of FS was also observed in different parts of the country. […] The prevalence rate of FS among other childhood convulsions in central Iran was 40.03% (95% CI: 37.09%-42.07%), in the east it was 59.4% (95% CI: 38.2%-80.7%), 44.1% (95% CI: 37.4%-50.8%) in the south, and 57.5% (95% CI: 49.1%-65.9%) in western Iran. According to the data, the lowest prevalence was observed in the north of the country 33.0% (95% CI: 24.5%-41.5%). […] The pooled prevalence of childhood febrile seizures (among other convolutions) in Iran was 47.9% (95% CI; 38.8-59.9%).
#11 The Prevalence of Febrile Seizure and Associated Factors Among Turkish Children | Carman | International Journal of Clinical Pediatrics
https://www.theijcp.org/index.php/ijcp/article/view/134/97
The aim of the present study was to determine the prevalence and risk factors of febrile seizure (FS) in Eskisehir province, Turkey. […] The prevalence of FS was calculated to be 2.57%. […] Although the prevalence of FS might vary according to the methodology of study, this present study found that the prevalence of FS was 2.57% among Turkish children. […] Epidemiologic studies have indicated that FSs are age-specific occurrences, with most episodes occurring when children between the ages of 3 months and 5 years. […] Although FS is the most common seizure disorder in childhood, the prevalence and incidence of FS varies by geographic location. […] The study reveals that attendance to day care center affects the prevalence of FS, with the risk of FS being 19.35 times higher if child attends to day care. Also familial history of FS and consanguinity of parents increase the risk of their children whose FS is 7.52 and 13.1 times higher, respectively. […] In the present study conducted in Turkeys Eskisehir province, the prevalence of FS was found to be 2.57%. […] The attendance to day care center, familial history of FS and consanguinity of parents were risk factors of FS on multivariate analysis.
#12 Prevalence of Febrile Seizures in School-Aged Children: A Community Based Survey in Ä°zmir, Turkey – The Journal of Pediatric Research
https://jpedres.org/articles/prevalence-of-febrile-seizures-in-school-aged-children-a-community-based-survey-in-izmir-turkey/doi/jpr.29290
The prevalence of FS in our study was found to be 4.8%. Our result is similar to the literature from Western countries while our prevalence rate is lower than Asian and African countries. The cause for higher prevalence rates in Asian and African countries is not known. It is hypothesized that it may be due to a different genetic predisposition as well as the influence of environmental factors. […] We found a lower prevalence rate compared to the study by Aydin et al. in which the prevalence was 9.7% in Izmir. Moreover, in another study, researchers reported the FS prevalence as 12.8% in Izmir. These differences might be due to methodological variations between studies. […] Our study supports findings that the prevalence of FS in our country is similar to developed countries but lower than the developing Asian communities. It was thought that increasing the awareness of febrile illness of parents and the advancing healthcare systems in our country may have decreased the FS prevalence within the last 8 years in Izmir.
#13 Prevalence of Febrile Seizures in School-Aged Children: A Community Based Survey in Ä°zmir, Turkey – The Journal of Pediatric Research
https://jpedres.org/articles/prevalence-of-febrile-seizures-in-school-aged-children-a-community-based-survey-in-izmir-turkey/doi/jpr.29290
The prevalence of FS in our study was found to be 4.8%. Our result is similar to the literature from Western countries while our prevalence rate is lower than Asian and African countries. The cause for higher prevalence rates in Asian and African countries is not known. It is hypothesized that it may be due to a different genetic predisposition as well as the influence of environmental factors. […] We found a lower prevalence rate compared to the study by Aydin et al. in which the prevalence was 9.7% in Izmir. Moreover, in another study, researchers reported the FS prevalence as 12.8% in Izmir. These differences might be due to methodological variations between studies. […] Our study supports findings that the prevalence of FS in our country is similar to developed countries but lower than the developing Asian communities. It was thought that increasing the awareness of febrile illness of parents and the advancing healthcare systems in our country may have decreased the FS prevalence within the last 8 years in Izmir.
#14 Epidemiology of febrile seizures and epilepsy: a call for action | Jornal de Pediatria
https://jped.elsevier.es/en-epidemiology-febrile-seizures-epilepsy-call-articulo-S0021755715001254
Seizures triggered by fever, qualified as febrile seizures, have been for decades a major issue for children in developed countries and more so in resource-limited settings. Approximately 25% of children are affected by this kind of seizure. […] In this issue of Jornal de Pediatria, Dalbem et al. report a population-based cross-sectional study conducted in the city of Barra do Bugres in Brazil to assess the prevalence of benign febrile seizures during childhood. The main outcome was a prevalence of 6.4/1000 habitants (95% confidence interval [CI], 3.8-10.1), which is much lower than the results reported in two studies also performed in Brazil, ranging from 13.9 to 16.0/1000, but within the literature range, from 3.5/1000 in an Arab population to 17.0/1000 in a rural north American population.
#15 Febrile seizures: a population-based study | Jornal de Pediatria
https://www.jped.com.br/en-febrile-seizures-population-based-study-articulo-S0021755715000649
To determine the prevalence of benign febrile seizures of childhood and describe the clinical and epidemiological profile of this population. […] The prevalence was 6.4/1000 inhabitants (95% CI: 3.8-10.1). […] The prevalence of febrile seizures in Midwestern Brazil was lower than that found in other Brazilian regions, probably due to the inclusion only of febrile seizures with motor manifestations and differences in socioeconomic factors among the evaluated areas. […] Febrile seizures are the most common seizures in children younger than 5 years, affecting 25% of the pediatric population; they are considered to be benign and self-limited, and are classified as simple and complex. […] The clinical signs of febrile seizures are not different among populations, but the clinical and demographic characteristics are not identical in the different parts of the world, thus justifying the necessity of the present study.
#16
https://aesnet.org/abstractslisting/prevalence-of-febrile-seizures-in-korean-children-using-the-big-data
Febrile seizures (FS) are the most common seizures of childhood, occurring in 2 to 5 percent of children six months to five years of age. […] The annual prevalence of FS determined by hospital-visiting rate in Korea was 1.4%, 1.5% in boys and 1.2% in girls in age below 5 years old. […] The prevalence has a peak in the third year of life with 2.2%. […] Monthly prevalence showed FS risk is higher during April to July as 42.3% (Mann-Whitney test, P=0.0001). […] Our study showed overall prevalence of FS using a data of total population in Korea. The prevalence is within a range of those reported in other country, and increased risk during warm weather needs further study with other correlating factors.
#17 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are the most common type of seizure in children between the ages of 6 months to 5 years. Febrile seizures are the most common type of seizures in childhood, with a slight male predominance of 1.6:1. Febrile seizures have an incidence of 2% to 5% of US and European children, which peaks between 12 to 18 months of age. A seasonal and diurnal association has also been observed in Japan, Finland, and the US, with more episodes occurring in the afternoon and winter months. Some children have a single febrile seizure event, while 30% of children have multiple seizures during early childhood. […] The evaluation of febrile seizures primarily consists of characterizing a patient’s type of febrile seizure and determining the fever’s underlying cause through clinical assessment and diagnostic studies. Most febrile seizures spontaneously resolve and, therefore, may be expectantly managed. However, complex or longer-lasting febrile seizures may require pharmacologic therapy to stop the seizure activity.
#18 Recent Research on Febrile Seizures: A Review
https://www.iomcworld.org/open-access/recent-research-on-febrile-seizures-a-review-45832.html
Febrile seizures are common and mostly benign. They are the most common cause of seizures in children less than five years of age. The incidence and prevalence of FS is similar across the numerous FS studies. There is variation of incidence of FS based on geographic location, with higher prevalence found in Japan and Guam. FS have a peak incidence at 18 months of age and are most common between 6 months and 5 years. Most FS are simple with approximately 20-30% being complex. The distribution of a first FS duration can be described using a two population model, one with short seizure duration and the other with long seizure duration, with the cut-off at approximately 10 minutes. By definition, a febrile illness is required for a child to have a FS. Children with FS have higher temperatures with illness compared to febrile controls. FS occur in the setting of a febrile illness, which could cause seasonal variation. In Japan a study of FS showed two peaks of incidence, November to January and June to August, which correspond to peaks of viral upper respiratory infections and gastrointestinal infections respectively. A study performed in Italy, which looked at 188 first FS, found that there is a significant increase in FS from 6 PM to 11:59 PM and a seasonal peak in January. There have been multiple studies have supported the conclusion that FS have a peak in the winter and end of the summer. Influenza A has been found to have a significant relationship with recurrence of FS. The risk of recurrence is influenced by both the age of the child and the type of FS. About one-third of children with a first FS will have a recurrence. Risk factors for recurrence include family history of FS, less than 18 months of age, temperature lower than 40.0C at first convulsion and less than 1 hour between onset of febrile illness and first convulsion. The numbers of risk factors are directly proportional to the risk of recurrence. A child with two or more risk factors has a more than 30% recurrence risk at 2 years of age, and that risk doubles with three risk factors. There is evidence that FS are associated with an increased risk of subsequent epilepsy, and that epilepsy develops in 2 to 4% of children with a history of FS. Although it is accepted that a single brief simple FS is benign with no clinical consequences, the risk of developing epilepsy can be as great as 57% in children with focal, prolonged, and recurrent FS.
#19 Snotwatch: an ecological analysis of the relationship between febrile seizures and respiratory virus activity | BMC Pediatrics | Full Text
https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03222-4
We found a 1.75-2.06 annual risk ratio of febrile seizure incidence in June-September. […] Our ecological study statistically demonstrates the recognised winter peak in febrile seizure incidence and ascribes the seasonal relationship to several viral infections which affect the community, including a novel association with Human metapneumovirus. […] Febrile seizures are the most common cause of seizure in childhood, with an incidence of 25% in North America and Europe. […] Viral infections are well-described as the predominant causative agents in febrile seizures, being detected in up to 82% of children with febrile seizures. […] Further, the seasonality of febrile seizures, which peaks in fall and winter, supports their association with spikes in the incidence of upper respiratory tract infections (URTIs) and their causative viruses.
#20
https://aesnet.org/abstractslisting/prevalence-of-febrile-seizures-in-korean-children-using-the-big-data
Febrile seizures (FS) are the most common seizures of childhood, occurring in 2 to 5 percent of children six months to five years of age. […] The annual prevalence of FS determined by hospital-visiting rate in Korea was 1.4%, 1.5% in boys and 1.2% in girls in age below 5 years old. […] The prevalence has a peak in the third year of life with 2.2%. […] Monthly prevalence showed FS risk is higher during April to July as 42.3% (Mann-Whitney test, P=0.0001). […] Our study showed overall prevalence of FS using a data of total population in Korea. The prevalence is within a range of those reported in other country, and increased risk during warm weather needs further study with other correlating factors.
#21 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are the most common type of seizure in children between the ages of 6 months to 5 years. Febrile seizures are the most common type of seizures in childhood, with a slight male predominance of 1.6:1. Febrile seizures have an incidence of 2% to 5% of US and European children, which peaks between 12 to 18 months of age. A seasonal and diurnal association has also been observed in Japan, Finland, and the US, with more episodes occurring in the afternoon and winter months. Some children have a single febrile seizure event, while 30% of children have multiple seizures during early childhood. […] The evaluation of febrile seizures primarily consists of characterizing a patient’s type of febrile seizure and determining the fever’s underlying cause through clinical assessment and diagnostic studies. Most febrile seizures spontaneously resolve and, therefore, may be expectantly managed. However, complex or longer-lasting febrile seizures may require pharmacologic therapy to stop the seizure activity.
#22 Febrile Seizures: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/801500-overview
Between 2% and 5% of children have febrile seizures by their fifth birthday. […] A similar rate of febrile seizures is found in Western Europe. The incidence elsewhere in the world varies between 5% and 10% for India, 8.8% for Japan, 14% for Guam, 0.35% for Hong Kong, and 0.5-1.5% for China. […] Febrile seizures occur in all races. […] Some studies demonstrate a slight male predominance. […] By definition, febrile seizures occur in children aged 3 months to 5 years. The highest incidence of febrile seizures has been reported in children aged 12-18 months.
#23 Febrile and First-Time Seizures | FreeCME.com
https://www.freecme.com/clinical-resources/pediatric-medicine-resources/febrile-and-first-time-seizures
Febrile seizure occurs in 2% to 5% of children, making it the most common cause of convulsive activity in children younger than 60 months of age. The incidence of febrile seizure appears to have increased slightly in the past 25 years. Between 25% to 30% of febrile seizures are classified as complex. A large population study in Denmark found that febrile seizures were more common in boys than girls (21% relative risk difference). The researchers also found that the highest incidence of febrile seizure was around 16 months of age and that more than 90% of children with a diagnosis of febrile seizure had their first febrile seizure before age 3 years. As many as one in 10 children with febrile seizures develop FSE, which accounts for 25% of the status epilepticus seen in children. […] The cumulative risk for recurrent febrile seizure after the first seizure is 22.7%, with no difference between boys and girls. The risk of recurrence increases with each subsequent simple febrile seizure the patient has in a lifetime: 35.6% chance of recurrence after the second febrile seizure, and 43.5% chance after the third.
#24 Best practices for the management of febrile seizures in children | Italian Journal of Pediatrics | Full Text
https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01666-1
Febrile seizures (FS) affect approximately 25% of children in the United States and Western Europe and 6 to 9% among Japanese ones. The peak incidence of the first FS typically occurs during the second year of a child’s life. The precise causes of FS remain not entirely clear. Factors statistically correlated with FS encompass a family history of such seizures, indications of neurological dysfunction or developmental disabilities, delayed neonatal discharge, and attendance at day care. The prevailing etiopathogenic hypothesis is that FS has a notable genetic predisposition. If a child experiences FS, the risk that their sibling will also experience one ranges from 10 to 45%. Monozygotic twins exhibit higher concordance rates for FS compared to dizygotic twins (53% versus 18%). Notably, compelling evidence has emerged from linkage studies, reporting linkages on multiple chromosomes such as 2q, 5q, 8q, 19p, and 19q, with the most robust linkage on chromosome 2q and specifically to genes responsible for sodium channel receptors. FS can occur in older children, albeit very rarely after the age of 6 years.
#25 The Prevalence of Febrile Seizure and Associated Factors Among Turkish Children | Carman | International Journal of Clinical Pediatrics
https://www.theijcp.org/index.php/ijcp/article/view/134/97
The aim of the present study was to determine the prevalence and risk factors of febrile seizure (FS) in Eskisehir province, Turkey. […] The prevalence of FS was calculated to be 2.57%. […] Although the prevalence of FS might vary according to the methodology of study, this present study found that the prevalence of FS was 2.57% among Turkish children. […] Epidemiologic studies have indicated that FSs are age-specific occurrences, with most episodes occurring when children between the ages of 3 months and 5 years. […] Although FS is the most common seizure disorder in childhood, the prevalence and incidence of FS varies by geographic location. […] The study reveals that attendance to day care center affects the prevalence of FS, with the risk of FS being 19.35 times higher if child attends to day care. Also familial history of FS and consanguinity of parents increase the risk of their children whose FS is 7.52 and 13.1 times higher, respectively. […] In the present study conducted in Turkeys Eskisehir province, the prevalence of FS was found to be 2.57%. […] The attendance to day care center, familial history of FS and consanguinity of parents were risk factors of FS on multivariate analysis.
#26 Best practices for the management of febrile seizures in children | Italian Journal of Pediatrics | Full Text
https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01666-1
Febrile seizures (FS) affect approximately 25% of children in the United States and Western Europe and 6 to 9% among Japanese ones. The peak incidence of the first FS typically occurs during the second year of a child’s life. The precise causes of FS remain not entirely clear. Factors statistically correlated with FS encompass a family history of such seizures, indications of neurological dysfunction or developmental disabilities, delayed neonatal discharge, and attendance at day care. The prevailing etiopathogenic hypothesis is that FS has a notable genetic predisposition. If a child experiences FS, the risk that their sibling will also experience one ranges from 10 to 45%. Monozygotic twins exhibit higher concordance rates for FS compared to dizygotic twins (53% versus 18%). Notably, compelling evidence has emerged from linkage studies, reporting linkages on multiple chromosomes such as 2q, 5q, 8q, 19p, and 19q, with the most robust linkage on chromosome 2q and specifically to genes responsible for sodium channel receptors. FS can occur in older children, albeit very rarely after the age of 6 years.
#27 Best practices for the management of febrile seizures in children | Italian Journal of Pediatrics | Full Text
https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01666-1
Febrile seizures (FS) affect approximately 25% of children in the United States and Western Europe and 6 to 9% among Japanese ones. The peak incidence of the first FS typically occurs during the second year of a child’s life. The precise causes of FS remain not entirely clear. Factors statistically correlated with FS encompass a family history of such seizures, indications of neurological dysfunction or developmental disabilities, delayed neonatal discharge, and attendance at day care. The prevailing etiopathogenic hypothesis is that FS has a notable genetic predisposition. If a child experiences FS, the risk that their sibling will also experience one ranges from 10 to 45%. Monozygotic twins exhibit higher concordance rates for FS compared to dizygotic twins (53% versus 18%). Notably, compelling evidence has emerged from linkage studies, reporting linkages on multiple chromosomes such as 2q, 5q, 8q, 19p, and 19q, with the most robust linkage on chromosome 2q and specifically to genes responsible for sodium channel receptors. FS can occur in older children, albeit very rarely after the age of 6 years.
#28 Febrile seizures: an overview – Drugs in Context
https://www.drugsincontext.com/febrile-seizures-an-overview/
Febrile seizures are the most common neurologic disorder in childhood. […] Febrile seizures, with a peak incidence between 12 and 18 months of age, likely result from a vulnerability of the developing central nervous system to the effects of fever, in combination with an underlying genetic predisposition and environmental factors. The majority of febrile seizures occur within 24 hours of the onset of the fever. […] Approximately 30-40% of children with a febrile seizure will have a recurrence during early childhood. […] Continuous preventative antiepileptic therapy for the prevention of recurrent febrile seizures is not recommended. The use of intermittent anticonvulsant therapy is not routinely indicated. Antipyretics have no role in the prevention of febrile seizures.
#29 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are the most common type of seizure in children between the ages of 6 months to 5 years. Febrile seizures are the most common type of seizures in childhood, with a slight male predominance of 1.6:1. Febrile seizures have an incidence of 2% to 5% of US and European children, which peaks between 12 to 18 months of age. A seasonal and diurnal association has also been observed in Japan, Finland, and the US, with more episodes occurring in the afternoon and winter months. Some children have a single febrile seizure event, while 30% of children have multiple seizures during early childhood. […] The evaluation of febrile seizures primarily consists of characterizing a patient’s type of febrile seizure and determining the fever’s underlying cause through clinical assessment and diagnostic studies. Most febrile seizures spontaneously resolve and, therefore, may be expectantly managed. However, complex or longer-lasting febrile seizures may require pharmacologic therapy to stop the seizure activity.
#30 Febrile and First-Time Seizures | FreeCME.com
https://www.freecme.com/clinical-resources/pediatric-medicine-resources/febrile-and-first-time-seizures
Febrile seizure occurs in 2% to 5% of children, making it the most common cause of convulsive activity in children younger than 60 months of age. The incidence of febrile seizure appears to have increased slightly in the past 25 years. Between 25% to 30% of febrile seizures are classified as complex. A large population study in Denmark found that febrile seizures were more common in boys than girls (21% relative risk difference). The researchers also found that the highest incidence of febrile seizure was around 16 months of age and that more than 90% of children with a diagnosis of febrile seizure had their first febrile seizure before age 3 years. As many as one in 10 children with febrile seizures develop FSE, which accounts for 25% of the status epilepticus seen in children. […] The cumulative risk for recurrent febrile seizure after the first seizure is 22.7%, with no difference between boys and girls. The risk of recurrence increases with each subsequent simple febrile seizure the patient has in a lifetime: 35.6% chance of recurrence after the second febrile seizure, and 43.5% chance after the third.
#31 Recent Research on Febrile Seizures: A Review
https://www.iomcworld.org/open-access/recent-research-on-febrile-seizures-a-review-45832.html
Febrile seizures are common and mostly benign. They are the most common cause of seizures in children less than five years of age. The incidence and prevalence of FS is similar across the numerous FS studies. There is variation of incidence of FS based on geographic location, with higher prevalence found in Japan and Guam. FS have a peak incidence at 18 months of age and are most common between 6 months and 5 years. Most FS are simple with approximately 20-30% being complex. The distribution of a first FS duration can be described using a two population model, one with short seizure duration and the other with long seizure duration, with the cut-off at approximately 10 minutes. By definition, a febrile illness is required for a child to have a FS. Children with FS have higher temperatures with illness compared to febrile controls. FS occur in the setting of a febrile illness, which could cause seasonal variation. In Japan a study of FS showed two peaks of incidence, November to January and June to August, which correspond to peaks of viral upper respiratory infections and gastrointestinal infections respectively. A study performed in Italy, which looked at 188 first FS, found that there is a significant increase in FS from 6 PM to 11:59 PM and a seasonal peak in January. There have been multiple studies have supported the conclusion that FS have a peak in the winter and end of the summer. Influenza A has been found to have a significant relationship with recurrence of FS. The risk of recurrence is influenced by both the age of the child and the type of FS. About one-third of children with a first FS will have a recurrence. Risk factors for recurrence include family history of FS, less than 18 months of age, temperature lower than 40.0C at first convulsion and less than 1 hour between onset of febrile illness and first convulsion. The numbers of risk factors are directly proportional to the risk of recurrence. A child with two or more risk factors has a more than 30% recurrence risk at 2 years of age, and that risk doubles with three risk factors. There is evidence that FS are associated with an increased risk of subsequent epilepsy, and that epilepsy develops in 2 to 4% of children with a history of FS. Although it is accepted that a single brief simple FS is benign with no clinical consequences, the risk of developing epilepsy can be as great as 57% in children with focal, prolonged, and recurrent FS.
#32 Recent Research on Febrile Seizures: A Review
https://www.iomcworld.org/open-access/recent-research-on-febrile-seizures-a-review-45832.html
Febrile seizures are common and mostly benign. They are the most common cause of seizures in children less than five years of age. The incidence and prevalence of FS is similar across the numerous FS studies. There is variation of incidence of FS based on geographic location, with higher prevalence found in Japan and Guam. FS have a peak incidence at 18 months of age and are most common between 6 months and 5 years. Most FS are simple with approximately 20-30% being complex. The distribution of a first FS duration can be described using a two population model, one with short seizure duration and the other with long seizure duration, with the cut-off at approximately 10 minutes. By definition, a febrile illness is required for a child to have a FS. Children with FS have higher temperatures with illness compared to febrile controls. FS occur in the setting of a febrile illness, which could cause seasonal variation. In Japan a study of FS showed two peaks of incidence, November to January and June to August, which correspond to peaks of viral upper respiratory infections and gastrointestinal infections respectively. A study performed in Italy, which looked at 188 first FS, found that there is a significant increase in FS from 6 PM to 11:59 PM and a seasonal peak in January. There have been multiple studies have supported the conclusion that FS have a peak in the winter and end of the summer. Influenza A has been found to have a significant relationship with recurrence of FS. The risk of recurrence is influenced by both the age of the child and the type of FS. About one-third of children with a first FS will have a recurrence. Risk factors for recurrence include family history of FS, less than 18 months of age, temperature lower than 40.0C at first convulsion and less than 1 hour between onset of febrile illness and first convulsion. The numbers of risk factors are directly proportional to the risk of recurrence. A child with two or more risk factors has a more than 30% recurrence risk at 2 years of age, and that risk doubles with three risk factors. There is evidence that FS are associated with an increased risk of subsequent epilepsy, and that epilepsy develops in 2 to 4% of children with a history of FS. Although it is accepted that a single brief simple FS is benign with no clinical consequences, the risk of developing epilepsy can be as great as 57% in children with focal, prolonged, and recurrent FS.
#33 :: JCN :: Journal of Clinical Neurology
https://www.thejcn.com/DOIx.php?id=10.3988/jcn.2018.14.1.43
The risk of developing epilepsy after a simple FS episode has been reported as 2-3%. […] The prevalence rate does differ between regions, such as being 8.2% in Fuchu, Japan, 14% in Guam, and 34.0% in Australia. […] The 5-year prevalence of FS in Korea was 6.92%, which was higher than the reported mean prevalence of 25%. […] The incidence of FS was previously reported to peak at 18 months, which is similar to our estimated results. […] The reported recurrence rate of FS has ranged from 30% to 40%, which is much higher than the rate observed in the present study. […] Only 3.35% of the FS children included in this study experienced a third episode of FS, and previous studies have found rates of three occurrences of FS from 4.1% to 9%.
#34 Febrile Seizures Following Childhood Vaccinations, Including Influenza Vaccination | Influenza (Flu) | CDC
https://www.cdc.gov/flu/vaccine-safety/febrile.html
Most febrile seizures happen in children between the ages of 6 and 59 months. Up to 5% of young children will have at least one febrile seizure. The most common age range for children to have febrile seizures is 14-18 months. […] About 1 in 3 children who have one febrile seizure will have more febrile seizures during childhood. If a member of a child’s immediate family (a brother, sister, or parent) has had febrile seizures, that child is more likely to have a febrile seizure. […] Febrile seizures can be frightening, but nearly all children who have a febrile seizure recover quickly, are healthy afterwards, and do not have any permanent neurological damage. Febrile seizures do not make children more likely to develop epilepsy or any other seizure disorder. […] Vaccines can cause fevers, but febrile seizures are rare after vaccination. Importantly, getting sick with the flu also can cause febrile seizures.
#35 Best practices for the management of febrile seizures in children | Italian Journal of Pediatrics | Full Text
https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01666-1
Approximately 30-50% of children who experience their first FS will have subsequent episodes of FS. One of the most extensively studied negative prognostic factors is a family history of FS. Recurrences seem to be more likely in children whose initial FS occurred with a relatively low fever and a short duration between the onset of fever and FS. Identifying independent factors, including a young age at onset, a history of FS in a first-degree relative, a low degree of fever at the emergency department, and a brief duration between the onset of fever and the initial seizure, has shown that children with all four of these factors have a recurrence risk for FS of 70%, whereas those with no factors have a recurrence risk of only 20%. […] Individuals with FS seizures have a risk of subsequent epilepsy of 1%, which is higher than that in the general population but not clinically significant. Conversely, complex FS are followed by epilepsy in 4-15%, depending on the number of complex features. From early observations, prior neurological and developmental status, and FS with complex features have been recognized as important predictors of epilepsy. More recently, the main prognostic factors for the development of epilepsy after FS have been identified as complex FS, which increases the risk by 3.6 times, age at onset of FS beyond the third year of life, which raises the risk by 3.8 times, a positive family history of epilepsy, which increases the risk by 7.3 times, and multiple episodes of FS, which raises the risk by about 10 times.
#36 Snotwatch: an ecological analysis of the relationship between febrile seizures and respiratory virus activity | BMC Pediatrics | Full Text
https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03222-4
We found a 1.75-2.06 annual risk ratio of febrile seizure incidence in June-September. […] Our ecological study statistically demonstrates the recognised winter peak in febrile seizure incidence and ascribes the seasonal relationship to several viral infections which affect the community, including a novel association with Human metapneumovirus. […] Febrile seizures are the most common cause of seizure in childhood, with an incidence of 25% in North America and Europe. […] Viral infections are well-described as the predominant causative agents in febrile seizures, being detected in up to 82% of children with febrile seizures. […] Further, the seasonality of febrile seizures, which peaks in fall and winter, supports their association with spikes in the incidence of upper respiratory tract infections (URTIs) and their causative viruses.
#37 Management of Pediatric Febrile Seizures
https://www.mdpi.com/1660-4601/15/10/2232
The most frequent infections associated with FS in children are chickenpox, influenza, middle ear infections, upper and lower airway infections (such as tonsillitis, pneumonia, bronchitis and sinusitis), tooth infections, and gastroenteritis (especially those caused by rotavirus). […] Considering the frequent inappropriate prescription of diagnostic examinations and the abuse of drugs in children with FS, the aim of this review is to focus on the management of FS in the pediatric age.
#38
https://journals.lww.com/pidj/fulltext/9900/epidemiology_of_febrile_seizures_during_the.1224.aspx
Active surveillance for febrile seizures was conducted at 12 Canadian pediatric centers (August 2021-December 2022). Of 3367 cases, 649 (19%) were hospitalized, 156/3367 (5%) had laboratory-confirmed acute SARS-CoV-2 infection, 363 (11%) had non-SARS-CoV-2 infection and 107 (3%) occurred as adverse events following immunization (vaccinated within 15 days before presentation). Febrile seizures were more frequently associated with infection than vaccination. […] The Canadian Immunization Monitoring Program Active (IMPACT) conducted active sentinel surveillance for hospitalizations for vaccine-preventable diseases and selected adverse events following immunization (AEFIs), including febrile seizure, at pediatric tertiary care centers from 1991 to 2023. The study objective was to describe the epidemiology of febrile seizure among children presenting to IMPACT centers and association with infection and vaccination during the Delta and Omicron periods.
#39
https://journals.lww.com/pidj/fulltext/9900/epidemiology_of_febrile_seizures_during_the.1224.aspx
Active surveillance for febrile seizures was conducted at 12 Canadian pediatric centers (August 2021-December 2022). Of 3367 cases, 649 (19%) were hospitalized, 156/3367 (5%) had laboratory-confirmed acute SARS-CoV-2 infection, 363 (11%) had non-SARS-CoV-2 infection and 107 (3%) occurred as adverse events following immunization (vaccinated within 15 days before presentation). Febrile seizures were more frequently associated with infection than vaccination. […] The Canadian Immunization Monitoring Program Active (IMPACT) conducted active sentinel surveillance for hospitalizations for vaccine-preventable diseases and selected adverse events following immunization (AEFIs), including febrile seizure, at pediatric tertiary care centers from 1991 to 2023. The study objective was to describe the epidemiology of febrile seizure among children presenting to IMPACT centers and association with infection and vaccination during the Delta and Omicron periods.
#40 Febrile seizures | PAEDS
https://paeds.org.au/surveillance-and-research/febrile-seizures
Febrile seizures are the most common type of childhood seizures, occurring 1 in 30 children aged 6 months to 6 years. They are associated with a sudden rise in temperature, most often from a viral illness. Certain vaccines, including measles-containing vaccines and some influenza vaccines, have been associated with an increased risk of febrile seizures. A PAEDS study was conducted between May 2013 and June 2014, gathering detailed clinical and epidemiological information on all febrile seizure presentations to 5 PAEDS sites. These data were used to determine the risk of febrile seizures following the introduction of new vaccines on the National Immunisation Program and to compare clinical outcomes of children who experienced a febrile seizure following a vaccination with children who experienced a febrile seizure unrelated to a vaccination event. The results of these studies have been published. In addition, children in this study were invited to participate in an NHMRC-funded longer-term follow-up study, led by Associate Professor Nicholas Wood, examining these childrens developmental outcomes and genetic susceptibility to febrile seizures compared with healthy children.
#41 Febrile Seizures Following Childhood Vaccinations, Including Influenza Vaccination | Influenza (Flu) | CDC
https://www.cdc.gov/flu/vaccine-safety/febrile.html
Several studies of children in the United States have looked at whether flu vaccination is associated with an increased risk for febrile seizures. […] Flu vaccine was not found to be associated with febrile seizures in one study that looked at 45,000 children aged 6 months through 23 months of age who received a flu vaccine from 1991 through 2003. […] Seasonal flu vaccine and the 2009 H1N1 flu vaccine were not found to be associated with febrile seizures in children during the 2009-2010 flu season. […] Some studies have detected a small increased risk of febrile seizures in young children following the flu shot in some flu seasons. In these studies, the risk of febrile seizures was increased for children 12 through 23 months of age, particularly when the flu shot was given at the same time as pneumococcal conjugate vaccine (PCV13) and diphtheria, tetanus, and pertussis (DTaP)-containing vaccine.
#42 Febrile Seizures Following Childhood Vaccinations, Including Influenza Vaccination | Influenza (Flu) | CDC
https://www.cdc.gov/flu/vaccine-safety/febrile.html
After carefully reviewing the data on febrile seizures and considering the benefits of vaccinating children against these illnesses, the CDC decided that no changes in the childhood immunization recommendations should be made. […] Febrile seizures after a childhood vaccination can be reported to CDC via the Vaccine Adverse Event Reporting System (VAERS).
#43 Best practices for the management of febrile seizures in children | Italian Journal of Pediatrics | Full Text
https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01666-1
The use of antipyretic medications may provide relief for a feverish child but it does not prevent FS. Well-constructed randomized trials of appropriate doses of acetaminophen, ibuprofen, and rectal diclofenac have failed to show any benefit in preventing FS. Consistently, a recent systematic review did not find a clear benefit of using antipyretics to prevent FS within the same fever episode and during distant fever episodes. […] FS are not a reason to avoid vaccinations. Vaccinations help prevent infections caused by common viruses or bacteria that can trigger FS, ultimately reducing the overall risk. However, the preventive impact of antipyretic medications on FS occurring after vaccination is not currently established.
#44
https://journals.lww.com/pidj/fulltext/9900/epidemiology_of_febrile_seizures_during_the.1224.aspx
In Canada during the COVID-19 pandemic, the febrile seizure risk continued to peak in the second year of life and had a slight male predominance. Only 13.9% of hospitalized febrile seizure cases tested positive for SARS-CoV-2 infection despite high community transmission of SARS-CoV-2, with population seroprevalence increasing from approximately 9% to 75% during the surveillance period. […] In Canada from 2021 to 2022, febrile seizures in young children continued to be more frequently associated with intercurrent infection than vaccination, with most postvaccination febrile seizures being temporally associated with MMRV. Despite high community transmission of SARS-CoV-2 during 2022, non-SARS-CoV-2 infections accounted for the majority of infections among children with febrile seizure hospitalization. These results inform our understanding of the association of febrile seizure with vaccination and infection in the COVID-19 era.
#45
https://aesnet.org/abstractslisting/impact-of-covid-19-on-the-epidemiology-of-respiratory-viral-infections-and-clinical-characteristics-of-associated-febrile-seizures
Viral infections of the upper respiratory tract are one of the most common causes of febrile seizures. […] The overall incidence of febrile seizures decreased during the coronavirus disease 2019 pandemic compared to that before the pandemic. […] A substantial reduction in the incidence of influenza virus infections was observed (p 0.001) during the pandemic, while the incidence of rhinovirus infection was not significantly changed (p = 0.811). […] Interestingly, a significantly high incidence of parainfluenza virus (p = 0.001) infections was observed during the pandemic. […] No statistically significant between-group differences were observed in the clinical presentation and outcomes of febrile seizures before and during the pandemic.
#46
https://aesnet.org/abstractslisting/impact-of-covid-19-on-the-epidemiology-of-respiratory-viral-infections-and-clinical-characteristics-of-associated-febrile-seizures
Viral infections of the upper respiratory tract are one of the most common causes of febrile seizures. […] The overall incidence of febrile seizures decreased during the coronavirus disease 2019 pandemic compared to that before the pandemic. […] A substantial reduction in the incidence of influenza virus infections was observed (p 0.001) during the pandemic, while the incidence of rhinovirus infection was not significantly changed (p = 0.811). […] Interestingly, a significantly high incidence of parainfluenza virus (p = 0.001) infections was observed during the pandemic. […] No statistically significant between-group differences were observed in the clinical presentation and outcomes of febrile seizures before and during the pandemic.
#47
https://journals.lww.com/pidj/fulltext/9900/epidemiology_of_febrile_seizures_during_the.1224.aspx
Active surveillance for febrile seizures was conducted at 12 Canadian pediatric centers (August 2021-December 2022). Of 3367 cases, 649 (19%) were hospitalized, 156/3367 (5%) had laboratory-confirmed acute SARS-CoV-2 infection, 363 (11%) had non-SARS-CoV-2 infection and 107 (3%) occurred as adverse events following immunization (vaccinated within 15 days before presentation). Febrile seizures were more frequently associated with infection than vaccination. […] The Canadian Immunization Monitoring Program Active (IMPACT) conducted active sentinel surveillance for hospitalizations for vaccine-preventable diseases and selected adverse events following immunization (AEFIs), including febrile seizure, at pediatric tertiary care centers from 1991 to 2023. The study objective was to describe the epidemiology of febrile seizure among children presenting to IMPACT centers and association with infection and vaccination during the Delta and Omicron periods.
#48 Febrile seizures | PAEDS
https://paeds.org.au/surveillance-and-research/febrile-seizures
Febrile seizures are the most common type of childhood seizures, occurring 1 in 30 children aged 6 months to 6 years. They are associated with a sudden rise in temperature, most often from a viral illness. Certain vaccines, including measles-containing vaccines and some influenza vaccines, have been associated with an increased risk of febrile seizures. A PAEDS study was conducted between May 2013 and June 2014, gathering detailed clinical and epidemiological information on all febrile seizure presentations to 5 PAEDS sites. These data were used to determine the risk of febrile seizures following the introduction of new vaccines on the National Immunisation Program and to compare clinical outcomes of children who experienced a febrile seizure following a vaccination with children who experienced a febrile seizure unrelated to a vaccination event. The results of these studies have been published. In addition, children in this study were invited to participate in an NHMRC-funded longer-term follow-up study, led by Associate Professor Nicholas Wood, examining these childrens developmental outcomes and genetic susceptibility to febrile seizures compared with healthy children.
#49 Snotwatch: an ecological analysis of the relationship between febrile seizures and respiratory virus activity | BMC Pediatrics | Full Text
https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03222-4
Recent innovations in viral respiratory molecular diagnostics allow multiple viruses to be tested simultaneously using multiplex polymerase chain reaction (PCR). […] This study examined the temporal associations between organism epidemiology and health outcomes across south-eastern Melbourne. […] Our study has established a method for studying temporal relationships of viruses to an illness of interest using independent datasets. […] The ability to estimate attributable proportion for specific viruses for conditions such as febrile seizures, offers the potential to inform organism specific disease burden and resultant health technology assessments for viral vaccines and therapeutics.
#50 Snotwatch: an ecological analysis of the relationship between febrile seizures and respiratory virus activity | BMC Pediatrics | Full Text
https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03222-4
Recent innovations in viral respiratory molecular diagnostics allow multiple viruses to be tested simultaneously using multiplex polymerase chain reaction (PCR). […] This study examined the temporal associations between organism epidemiology and health outcomes across south-eastern Melbourne. […] Our study has established a method for studying temporal relationships of viruses to an illness of interest using independent datasets. […] The ability to estimate attributable proportion for specific viruses for conditions such as febrile seizures, offers the potential to inform organism specific disease burden and resultant health technology assessments for viral vaccines and therapeutics.
#51 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are categorized as simple febrile seizures, consisting of a single seizure lasting 15 minutes or less, or complex febrile seizures, characterized by multiple seizures occurring within 24 hours with focal neurologic features or a seizure lasting 15 minutes or more. Simple febrile seizures comprise most febrile seizures. Febrile status epilepticus refers to seizures lasting longer than 30 minutes and is a rare subset of febrile seizures associated with more adverse outcomes than simple febrile seizures.
#52 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are categorized as simple febrile seizures, consisting of a single seizure lasting 15 minutes or less, or complex febrile seizures, characterized by multiple seizures occurring within 24 hours with focal neurologic features or a seizure lasting 15 minutes or more. Simple febrile seizures comprise most febrile seizures. Febrile status epilepticus refers to seizures lasting longer than 30 minutes and is a rare subset of febrile seizures associated with more adverse outcomes than simple febrile seizures.
#53 SeizuresâFebrile | 5-Minute Pediatric Consult
https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617318/all/Seizures%E2%80%93Febrile?q=Stroke
Most febrile seizures occur between 6 months and 3 years of age. […] Peak age is about 18 months. […] 6570% are simple febrile seizures. […] 2035% are complex febrile seizures. […] ~5% are febrile status epilepticus. […] Febrile seizures occur in 25% of children in the United States and Western Europe, 910% of children in Japan, and 14% of children in Guam.
#54 Outbreaks, Alerts and Hot Topics | Children’s Mercy Kansas City
https://www.childrensmercy.org/health-care-providers/refer-or-manage-a-patient/connect-with-childrens-mercy/newsletter-the-link/outbreaks-alerts-and-hot-topics-february-2022/
Febrile seizures occur between 6 months and 5 years of age in association with a fever (38C) without another identifiable source for seizures. Febrile seizures affect 2%-5% of children between the ages of 6 months and 5 years, making it the most common neurological disorder in this age group. Across all ages, seizures make up 1%-2% of all emergency department visits per year, a subset of which are febrile seizures. […] Simple febrile seizures present as generalized tonic-clonic seizures lasting 15 minutes without recurrence in a 24-hour period. These account for about 80%-85% of all febrile seizures. […] Complex febrile seizures are focal, prolonged (15 minutes), with a prolonged postictal state, and/or recurrence within a 24-hour period. […] Approximately 80% of febrile seizure cases occur with a viral infection. Additionally, the risk of febrile seizures increases a few days after the administration of DTaP-IPV-Hib, MMRV or PCV, though this risk is transient and small.
#55 Outbreaks, Alerts and Hot Topics | Children’s Mercy Kansas City
https://www.childrensmercy.org/health-care-providers/refer-or-manage-a-patient/connect-with-childrens-mercy/newsletter-the-link/outbreaks-alerts-and-hot-topics-february-2022/
Febrile seizures occur between 6 months and 5 years of age in association with a fever (38C) without another identifiable source for seizures. Febrile seizures affect 2%-5% of children between the ages of 6 months and 5 years, making it the most common neurological disorder in this age group. Across all ages, seizures make up 1%-2% of all emergency department visits per year, a subset of which are febrile seizures. […] Simple febrile seizures present as generalized tonic-clonic seizures lasting 15 minutes without recurrence in a 24-hour period. These account for about 80%-85% of all febrile seizures. […] Complex febrile seizures are focal, prolonged (15 minutes), with a prolonged postictal state, and/or recurrence within a 24-hour period. […] Approximately 80% of febrile seizure cases occur with a viral infection. Additionally, the risk of febrile seizures increases a few days after the administration of DTaP-IPV-Hib, MMRV or PCV, though this risk is transient and small.
#56 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are the most common type of seizure in children between the ages of 6 months to 5 years. Febrile seizures are the most common type of seizures in childhood, with a slight male predominance of 1.6:1. Febrile seizures have an incidence of 2% to 5% of US and European children, which peaks between 12 to 18 months of age. A seasonal and diurnal association has also been observed in Japan, Finland, and the US, with more episodes occurring in the afternoon and winter months. Some children have a single febrile seizure event, while 30% of children have multiple seizures during early childhood. […] The evaluation of febrile seizures primarily consists of characterizing a patient’s type of febrile seizure and determining the fever’s underlying cause through clinical assessment and diagnostic studies. Most febrile seizures spontaneously resolve and, therefore, may be expectantly managed. However, complex or longer-lasting febrile seizures may require pharmacologic therapy to stop the seizure activity.
#57 Febrile Seizure – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK448123/
Febrile seizures are the most common type of seizure in children between the ages of 6 months to 5 years. Febrile seizures are the most common type of seizures in childhood, with a slight male predominance of 1.6:1. Febrile seizures have an incidence of 2% to 5% of US and European children, which peaks between 12 to 18 months of age. A seasonal and diurnal association has also been observed in Japan, Finland, and the US, with more episodes occurring in the afternoon and winter months. Some children have a single febrile seizure event, while 30% of children have multiple seizures during early childhood. […] The evaluation of febrile seizures primarily consists of characterizing a patient’s type of febrile seizure and determining the fever’s underlying cause through clinical assessment and diagnostic studies. Most febrile seizures spontaneously resolve and, therefore, may be expectantly managed. However, complex or longer-lasting febrile seizures may require pharmacologic therapy to stop the seizure activity.