Prognosis And Influencing Factors In Children With The First Febrile Seizure

Purpose: To investigate the prognosis of children with their first febrile seizures(FS)and to analyze the factors affecting their prognosis.Methods:Data were collected from January 2016 to December 2017 from children who were hospitalized in the pediatric ward 1 of Handan Central Hospital and diagnosed with the first episode of FS,including gender,the age at the first episode,the temperature at the time of the episode,duration of fever before the episode,type of episode,week of gestation,neonatal intensive care unit(NICU)history,mode of delivery,family history of FS,video electroencephalogram(VEEG)and cranial magnetic resonance imaging(MRI).Children who met the inclusion criteria were followed up by telephone or outpatient until the age of ≥7 years,including the presence of FS recurrence,neurological developmental abnormalities,and conversion to epilepsy(EP).The children were divided into the non-epilepsy group and the epilepsy group according to the occurrence of EP,and the risk factors associated with the occurrence of EP in children with FS were compared between the two groups;the non-epilepsy group was further divided into non-recurrence group and the recurrence group according to the presence or absence of FS relapse,and the risk factors associated with the recurrence of FS were compared between the two groups.The data that was statistically significant(P < 0.05)in the one-way analysis were then included in the multi-factor logistic regression analysis to explore the independent adverse factors affecting recurrent seizures or the occurrence of EP in children with FS for the first time.Results:1.Of the 191 children,35 were in the epilepsy group,of whom 8 had only1 FS and 27 had ≥2 FS,and 156 were in the non-epilepsy group,of whom71 had only 1 FS and 85 had ≥2 FS.2.Univariate analysis suggested that the differences in the month of first seizure age,the temperature at the time of the episode,duration of fever before the episode,seizure type,gestational week status,history of NICU stay,mode of delivery,VEEG results,and recurrent FS were statistically significant between the non-epileptic and the epileptic groups(P < 0.05); the month of first seizure age,duration of fever before the episode,seizure type,history of NICU stay,mode of delivery,and family history of FS differences between the non-recurrent and the recurrent groups were statistically significant(P < 0.05).3.The results of multifactorial regression analysis showed that the month of age at first seizure,history of NICU stay,and VEEG results were independent factors influencing the occurrence of EP in children with FS(P< 0.05).The month of age of the first seizure,duration of fever before the seizure,and type of seizure were independent influencing factors for recurrence of FS(P < 0.05).Conclusion:1.Risk factors for the occurrence of EP in FS included the month of age at first seizure ≤ 12 months,the temperature ≤ 39.0°C at the time of seizure,duration of fever ≤ 1 hour before the seizure,complicated febrile convulsions,prematurity,history of NICU hospitalization,cesarean delivery,abnormal VEEG,and recurrent FS,of which age at first seizure ≤12 months,history of NICU hospitalization during the neonatal period,and abnormal VEEG results were independent risk factors.2.Risk factors for recurrent FS included the month age at first seizure ≤ 12 months,duration of fever ≤ 1 hour before the seizure,complicated febrile convulsions,history of NICU hospitalization,cesarean delivery,and family history of FS,which the month of age at first seizure ≤ 12 months,duration of fever ≤ 1 hour before the seizure,and complicated febrile convulsions were independent risk factors for recurrence.