PREDICTORS OF EPILEPSY IN CHILDREN WHO HAVE EXPERIENCED FEBRILE SEIZURES

The frequency of development of afebrile seizures was determined in 1706 children who had experienced at least 1 febrile seizure and were followed to the age of 7 yr. Epilepsy developed by 7 yr of age in 20/1000 (2%), and another 10/1000 had at least 1 afebrile seizure that did not meet this definition of epilepsy. In children whose neurologic or developmental status was suspect or abnormal before any seizure and whose 1st seizure was complex (longer than 15 min, multiple or focal) epilepsy developed at a rate 18 times higher than in children with no febrile seizures (92 vs. 5/1000; P < < 0.001). In the largest group with febrile seizures, those previously normal with noncomplex 1st febrile seizures, epilepsy developed in 11/1000; this rate, although moderate, was greater than that for children with no febrile seizures (P = 0.027). Prior neurologic and developmental status and characteristics of the 1st febrile seizure are important predictors of epilepsy after febrile seizures.