Prevalence of electrographic changes in patients with initial presentation of complex febrile seizures at the pediatric emergency care: retrospective analysis

*Correspondence: [e-mail].

Abstract

Background: Responsible for the most common neurological disorder in infants and young children, febrile seizures are defined as clinical expressions of abnormal neuronal discharges in the presence of fever. Age dependent, healthy children, without evidence of central nervous system infection, defined cause or previous non-febrile seizure, with a high incidence in young infants. Identificated as simple when presents with generalized semiology, less than 15 minutes, non-recurrence in 24 hours, being considered as benign phenomena. However, when focal, prolonged episodes, early recurrence, are classified as complex, with increased risk of developing epilepsy in the future, especially when electroencephalographic (EEG) changes and family history are evidenced.

Objective: Evaluate the prevalence of electroencephalographic changes in children with complex febrile seizures at the Emergency Care.

Methods: Analysis of medical records, retrospectively, during the period from January 2021 to January 2023, of patients with complex febrile seizures who subsequently underwent EEG. Patients with previous history of seizures, evidence of central nervous system (CNS) infection, history of prematurity, genetic syndromes and other potential causes of symptomatic changes in CNS were excluded.

Results: 42 children with complex febrile seizures were included, 16 girls (38%) and 26 males (62%). 10 had a positive family history for febrile seizures and/or epilepsy (24%). 17% presented with less than 1 year old, 43% were between 1 and 2 years old and 40% more than 2 years old. EEG alterations were evidenced in 16 patients (38%), 11 showed focal abnormalities (26%), 4 were nonspecific findings (9%) and 1 with base disorganization. Of the children who had a positive family history, 30% had a focal alteration. Neurophysiological alterations were evidenced in about 40% of the patients with complex febrile seizures, mainly with focal abnormalities, where about 30% of these had a positive family history and 80% with more than 2 years old.

Conclusion: Such data corroborate existing statistics that there is probably a greater risk of developing epilepsy in complex febrile seizures and with a positive family history, demonstrating focal electrographic alterations denote an anatomical substrate for this.

Publication History

Article published online:
12 May 2025