Letters to the Editor

Indian Pediatrics 2001; 38: 1433  

Risk Factors for Recurrence of Febrile Seizures

The authors had stated: "Recurrence risk is related to various risk factors, which may include the type of treatment. One study found a total of five risk factors for recurrent febrile seizures when no prophylaxis was given(2). In order of predictive power it included young age of onset (<15 months), epilepsy in first degree relative, febrile seizure in first degree relative, many subse-quent febrile episodes in Table I it was stated as many previous episodes of febrile seizured), and a first complex febrile seizure. The higher the number of risk factors. the higher the recurrence rate and vice versa."

A factor which contributes adversely by increasing the incidence or aggravating the manifestations of a disease, is called a ‘risk factor’. because presence or absence of this factor makes the difference. Among the five ‘risk factors’ stated "many subsequent febrile episodes/many previous episodes of febrile seizurers" are stated as number four risk factor. There are two components,(i) many subequent febrile episodes, and (ii), many previous episodes of febrile seizures.

Febrile seizures are defined as an event in neurologically healthy infants and children between 6 months and 5 years of age, associated with fever >38ºC rectal tempera-ture but without evidence of intracranial infection as a defined cause and with no history of prior afebrile seizures(3). Fever and seizures both are essential, seizure without fever cannot be called a febrile seizure. Every febrile episode in children between 6 months and 5 years of age does not result in seizure. Febrile episodes may and would occur between 6 months and 5 years of age following the first episode of febrile seizure. Following two points need clarification:

A. The issue under question is ‘prediction of recurrence of febrile seizures’, i.e., whether seizure will occur or not in subsequent febrile episode. How do ‘many subsequent febrile episodes’ form a risk?

B. ‘Many previous episodes’ means what has already happened, i.e., recurrence has occurred. How can ‘recurrence of febrile seizures’ help in predicting the chance of recurrence of febrile seizures? Is there any need to predict the risk of recurrence of febrile seizures when many previous episodes of febrile seizures have already occurred?

Yash Paul,
A-D-7, Devi Marg,
Bani Park,
Jaipur 302 016, India.

1. Singhi PD, Srinivas M. Febrile seizures. Indian Pediatr 2001; 38: 733-740.

2. Knudsen FU. Recurrence risk after first febrile seizure and effect for short term diazepam prophylaxis. Arch Dis Child 1985; 60: 1045-1049.

3. Consensus Development Panel. Febrile Seizures: Long-term management of children with fever associated seizures. Pediatrics 1980; 66: 1009-1012.