[P1-90] Factors prognostic of subsequent epilepsy after seizure with fever in children over 6 years old
Purpose: There is a paucity of evidence about prognosis after seizure with fever in older children. We studied about the prognosis and potential risk factors suggesting subsequent epilepsy after seizure with fever in patients over 6 years old.
Methods: Retrospectively, we reviewed all the patients who presented with seizure with fever in patients over 6 years old at the Korea University Guro, Anam and Ansan Hospital between 2012 and 2015. Data was collected by review of medical records and phone calls to their parents. Including patient demographics, duration and type of seizure, findings of EEG and brain MRI, and viral etiology were collected. The results are displayed by analysis of Kaplan-Meier. Univariate and multivariate analyses were performed with the Cox proportional-hazards model using SPSS version 22.0 (IMB SPSS Inc., New York, United States).
Results: Among 204 patients initially included, we excluded 45 children who were already diagnosed with epilepsy or had a history of unprovoked seizure. Also 20 children of short follow-up duration less than 6 months were excluded. Of 139 children, 56 patients had no history of seizure with fever before the age of 6 year. During follow-up (Mean ± SD, 26.8 ± 15.0 months), recurrent seizure occurred in 22 children (22/139, 15.8 %) and 13 of them had unprovoked seizure during follow-up. Multivariate analysis showed that multiple episodes of same febrile illness and family history of epilepsy are related to higher risk of recurrence (P-value=0.003 and 0.014, hazard ratio (HR) of 5.200 and 4.080). Developmental delay are related to higher risk of epilepsy (P-value=0.002, hazard ratio (HR) of 6.006). In 56 patients after 1st seizure with fever over 6 years old, multivariate analysis showed that multiple episodes of same febrile illness is related to higher risk of recurrence (P-value = 0.010, hazard ratio (HR) of 7.094, 95% confidence interval (CI) of 1.586-31.726). Developmental delay and treatment with IV anti-epileptic drug are related to higher risk of epilepsy (P-value=0.010 and 0.006, hazard ratio (HR) of 10.490 and 17.558).
Conclusions: In patients who had ever experienced seizure with fever over 6 years old, developmental delay is related to higher risk of subsequent epilepsy. In patients after 1st seizure with fever over 6 years old, developmental delay and treatment with IV anti-epileptic drug are related to higher risk of epilepsy. Long-term studies should be followed and larger population studies are needed to prove the predictors, especially in patients with 1st seizure with fever in older age.
Methods: Retrospectively, we reviewed all the patients who presented with seizure with fever in patients over 6 years old at the Korea University Guro, Anam and Ansan Hospital between 2012 and 2015. Data was collected by review of medical records and phone calls to their parents. Including patient demographics, duration and type of seizure, findings of EEG and brain MRI, and viral etiology were collected. The results are displayed by analysis of Kaplan-Meier. Univariate and multivariate analyses were performed with the Cox proportional-hazards model using SPSS version 22.0 (IMB SPSS Inc., New York, United States).
Results: Among 204 patients initially included, we excluded 45 children who were already diagnosed with epilepsy or had a history of unprovoked seizure. Also 20 children of short follow-up duration less than 6 months were excluded. Of 139 children, 56 patients had no history of seizure with fever before the age of 6 year. During follow-up (Mean ± SD, 26.8 ± 15.0 months), recurrent seizure occurred in 22 children (22/139, 15.8 %) and 13 of them had unprovoked seizure during follow-up. Multivariate analysis showed that multiple episodes of same febrile illness and family history of epilepsy are related to higher risk of recurrence (P-value=0.003 and 0.014, hazard ratio (HR) of 5.200 and 4.080). Developmental delay are related to higher risk of epilepsy (P-value=0.002, hazard ratio (HR) of 6.006). In 56 patients after 1st seizure with fever over 6 years old, multivariate analysis showed that multiple episodes of same febrile illness is related to higher risk of recurrence (P-value = 0.010, hazard ratio (HR) of 7.094, 95% confidence interval (CI) of 1.586-31.726). Developmental delay and treatment with IV anti-epileptic drug are related to higher risk of epilepsy (P-value=0.010 and 0.006, hazard ratio (HR) of 10.490 and 17.558).
Conclusions: In patients who had ever experienced seizure with fever over 6 years old, developmental delay is related to higher risk of subsequent epilepsy. In patients after 1st seizure with fever over 6 years old, developmental delay and treatment with IV anti-epileptic drug are related to higher risk of epilepsy. Long-term studies should be followed and larger population studies are needed to prove the predictors, especially in patients with 1st seizure with fever in older age.