By Megan Brooks
NEW YORK—Young children who suffer recurrent febrile seizures appear to be at increased risk of epilepsy and psychiatric disorders, according to a Danish population-based study.
"We undertook this study because febrile seizures is the most common neurological disorder in young children, yet we know very little about associated long-term consequences," Dr. Julie Werenberg Dreier of Aarhus University told Reuters Health by email.
"Until now, febrile seizures have generally been considered to be associated with a favorable prognosis, with little or no long-lasting implications for child development. However, the findings presented in this study cast doubt on whether this is in fact the case," she said.
"We recommend that parents and health care providers pay attention to early signs and symptoms of epilepsy and psychiatric disorders - especially in children with recurrent febrile seizures - in order to ensure early detection and appropriate treatment," Dr. Dreier added.
Using Danish registry data, the researchers evaluated the long-term risk of epilepsy and any diagnosed psychiatric disorder in children with recurrent febrile seizures.
Among more than 2.1 million children aged three months to five years, 3.6% had a first febrile seizure between 1977 and 2016. Febrile seizures were significantly more common in boys than girls (3.9% vs. 3.3%).
Children with a first febrile seizure had a 22.7% risk of having another, the team reports in JAMA Pediatrics, online October 7.
The risk of epilepsy increased progressively with the number of hospital admissions with febrile seizures. The 30-year cumulative risk of epilepsy was 2.2% at birth compared with 15.8% those who had had three febrile seizures.
The same was true for psychiatric disorders, with 30-year cumulative risk 17.2% at birth and 29.1% after the third febrile seizure. The researchers say these are likely conservative estimates of the overall burden of psychiatric disorders following febrile seizures because they only include people with psychiatric disorders needing treatment in secondary care. The risk of psychiatric disorders was significantly elevated even after adjusting for epilepsy.
Dr. Dreier said they did not look into which psychiatric disorders were most common. However, in a prior study the association was most pronounced for schizophrenia and related disorders.
"We are not sure whether this increased risk is actually attributable to the seizures themselves, or whether it may be due to some underlying factors," she noted. "Future research should look at the role of e.g. genetics to see whether this may explain why some children tend to have recurrent febrile seizures and later on also develop epilepsy and psychiatric disorders."
JAMA Pediatrics 2019.
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