Long-Term Intellectual and Behavioral Outcomes of Children with Febrile Convulsions

University of Bristol, Bristol, England, United Kingdom
New England Journal of Medicine (Impact Factor: 55.87). 07/1998; 338(24):1723-8. DOI: 10.1056/NEJM199806113382403
Source: PubMed


Hospital-based studies have reported that children with febrile convulsions have subsequent mental retardation and behavior problems. In contrast, population-based studies have reported a better outcome.
We identified 398 children with febrile convulsions among 14,676 children enrolled in the Child Health and Education Study, a national population-based study in the United Kingdom of children born in one week in April 1970. The children were comprehensively assessed at the age of 10. After excluding 16 children who had neurodevelopmental problems before their first febrile convulsion and 1 child whose case was atypical, we studied 381 children, 287 with simple febrile convulsions and 94 with complex febrile convulsions. We compared them with the rest of the cohort using measures of academic progress, intelligence, and behavior that included questionnaires, standardized tests, and formal tests.
At the 10-year assessment, only 4 of 102 measures of academic progress, intelligence, and behavior differed significantly between the entire group of children with febrile convulsions and the group without febrile convulsions -- no more than would be expected by chance. Similar results were found when children with simple febrile convulsions and those with complex febrile convulsions were analyzed separately. The children with recurrent episodes of febrile convulsions had outcomes similar to those of the children with only one episode each. Special schooling was required for more children who had febrile convulsions in the first year of life than for those who had had them later in life (5 of 67, or 7.5 percent, vs. 4 of 265, or 1.5 percent; P=0.02), but these numbers were small.
Children who had febrile convulsions performed as well as other children in terms of their academic progress, intellect, and behavior at 10 years of age.

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    • "Nevertheless, their IQ was still within the normal range. Moreover, studies have often used different durational cutoffs to each other, with some studies splitting their sample population into children that have seizures lasting less than and more than 15 min (e.g., Verity et al., 1998; Chang et al., 2000) and other studies using the 30-min durational cutoff adopted in the current study (e.g., Verity et al., 1993; van Esch et al., 1996). Given indications that seizures of the prolonged kind (>30 min) are the ones that carry an association with mesial temporal sclerosis (Meldrum & Brierley, 1973; Baram & Shinnar, 2001), the present study was designed specifically to only investigate those type of seizures. "
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