Original article| Volume 26, ISSUE 4, P241-244, June 2004

Treatment and outcome in patients with febrile convulsion associated with epileptiform discharges on electroencephalography


      The aim of this study is to determine the efficacy of prophylactic treatment for patients with febrile convulsions (FCs) in whom electroencephalograms (EEGs) revealed epileptiform discharges.
      We retrospectively investigated 43 patients who met the following criteria: (a) at least one FC during the study period; (b) epileptiform discharges were first recognized; (c) no unevoked seizures before epileptiform discharges were first seen; (d) normal psychomotor development and no neurological abnormality; and (e) follow-up >3 years. The clinical characteristics, treatment, and a later occurrence of FCs or unevoked seizures were studied.
      EEGs revealed focal epileptiform discharges in 25 patients and generalized ones in 18. There was no significant difference in the rate of recurrence of FC or occurrence of unevoked seizures between those with focal and generalized epileptiform discharges. No prophylaxis was performed in ten patients, 14 patients being treated with intermittent diazepam and 19 with a daily anticonvulsant. The rate of recurrence of FC was not significantly different between patients with and without prophylaxis. Unevoked seizures were only observed in two patients undergoing daily treatment.
      Intermittent or daily anticonvulsant therapy will not reduce the risk of recurrence of FCs or later development of unevoked seizures in patients with FC with epileptiform discharges.


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        • Nelson K.B
        • Ellenberg J.H
        Predictors of epilepsy in children who have experienced febrile seizures.
        N Eng J Med. 1976; 295: 1029-1033
        • Hirtz G
        • Lee Y.J
        • Ellenberg J.H
        • Nelson K.B
        Survey on the management of febrile seizures.
        Am J Dis Child. 1986; 140: 909-914
        • Committee on Quality Improvement
        Subcommittee on Febrile Seizures. Practice parameter: long-term treatment of the child with simple febrile seizures.
        Pediatrics. 1999; 103: 1307-1309
        • Baumann R.J
        • Duffner P.K
        Treatment of children with simple febrile seizures: the AAP practice parameter.
        Pediatr Neurol. 2000; 23: 11-17
        • Fukuyana Y
        • Seki T
        • Ohtsuka C
        • Miura H
        • Hara M
        Practical guideline for physicians in the management of febrile seizures.
        Brain Dev. 1996; 18: 479-484
        • Ohtahara S
        • Ishida S
        • Yamatogi Y
        • Oka E
        • Yoshida H
        • Matsuda M
        Studies on febrile convulsions: I. A neuroepidemiologic investigation on febrile convulsions in Tamano City, Okayama prefecture (in Japanese).
        No Kenkyukai Kaishi (Jpn J Neurosci Res Assoc) (Tokyo). 1984; 6: 365-372
        • Provisional Committee on Quality Improvement
        Subcommittee on Febrile Seizures. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure.
        Pediatrics. 1996; 97: 769-775
        • Aicardi J
        The medical management of neonatal or infantile seizure and of febrile seizures.
        in: Porter R.J Morselli P.L The epilepsies. Butterworth, London1986: 206-226
        • Stores G
        When does an EEG contribute to the management of febrile seizures?.
        Arch Dis Child. 1991; 66: 554-557
        • Maytal J
        • Eviatar R.S
        • Novak G
        The value of early postictal EEG in children with complex febrile seizures.
        Epilepsia. 2000; 41: 219-221
        • Verity C.M
        The place of the EEG and imaging in the management of seizures.
        Arch Dis Child. 1995; 73: 563-567
        • Verity C.M
        • Greenwood R
        • Golding J
        Long-term intellectual and behavioral outcomes of children with febrile convulsions.
        N Eng J Med. 1998; 338: 1723-1728
        • Annegers J.F
        • Hauser W.A
        • Shirts S.B
        • Kurland L.T
        Factors prognostic of unevoked seizures after febrile convulsions.
        N Eng J Med. 1987; 316: 493-498
        • Nelson K.B
        • Ellenberg J.H
        Prognosis in children with febrile seizures.
        Pediatrics. 1978; 61: 720-727