Affiliation:
1. Comprehensive Epilepsy Center NYU Langone Health New York New York USA
2. Department of Neurology NYU Langone Health and NYU Grossman School of Medicine New York New York USA
3. Health Sciences Library NYU Grossman School of Medicine New York New York USA
4. Department of Pathology NYU Langone Health and NYU Grossman School of Medicine New York New York USA
5. Center for Cognitive Neurology NYU Langone Health and NYU Grossman School of Medicine New York New York USA
6. Department of Psychiatry NYU Langone Health and NYU Grossman School of Medicine New York New York USA
Abstract
AbstractFebrile seizures affect 2%–5% of U.S. children and are considered benign although associated with an increased risk of epilepsy and, rarely, with sudden unexplained death. We compared rates of mortality, neurodevelopmental disorders, and neuropathology in young children with simple and complex febrile seizures to healthy controls. We systematically reviewed studies of 3‐ to 72‐month‐old children with simple or complex febrile seizures ≤30 min. We searched studies with outcome measures on mortality, neurodevelopment, or neuropathology through July 18, 2022. Bias risk was assessed per study design. Each outcome measure was stratified by study design. PROSPERO registration is CRD42022361645. Twenty‐six studies met criteria reporting mortality (11), neurodevelopment (11), and neuropathology (13), including 2665 children with febrile seizures and 1206 seizure‐free controls. Study designs varied: 15 cohort, 2 cross‐sectional, 3 case–control, 5 series, and 1 case report. Mortality outcomes showed stark contrasts. Six cohort studies following children after febrile seizure (n = 1348) reported no deaths, whereas four child death series and 1 case report identified 24.1% (108/449) deaths associated with simple (n = 104) and complex (n = 3) febrile seizures ≤30 min. Minor hippocampal histopathological anomalies were common in sudden deaths with or without febrile seizure history. Most electroencephalography (EEG) studies were normal. Neuroimaging studies suggested increased right hippocampal volumes. When present, neurodevelopmental problems usually preexisted febrile‐seizure onset. Risk bias was medium or high in 95% (18/19) of cohort and case–control studies vs medium to low across remaining study designs. Research on outcomes after simple or brief complex febrile seizures is limited. Cohort studies suffered from inadequate sample size, bias risk, and limited follow‐up durations to make valid conclusions on mortality, neurodevelopment, and neuropathology. Sudden death registries, focused on a very small percentage of all cases, strongly suggest that simple febrile seizures are associated with increased mortality. Although most children with febrile seizures have favorable outcomes, longer‐term prospective studies are needed.
Funder
Finding A Cure for Epilepsy and Seizures
National Center for Advancing Translational Sciences
Subject
Neurology (clinical),Neurology
Reference53 articles.
1. Febrile seizures: risks, evaluation, and prognosis;Smith DK;Am Fam Physician,2019
2. Current understanding of febrile seizures and their long‐term outcomes
3. National Institute of Neurological Disorders and Stroke N.Febrile seizures facts sheet. Available at:https://www.ninds.nih.gov/febrile‐seizures‐fact‐sheet
4. Risk factors of epilepsy in children with complex febrile seizures; A Retrospective cohort study
5. Sudden Unexpected Death in Childhood: A Report of 50 Cases
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