Febrile seizures: a population-based study

Dalbem, Juliane S.; Siqueira, Heloise H.; Espinosa, Mariano M.; Alvarenga, Regina P.

doi:10.1016/j.jped.2015.01.005

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Sumário

• J. Pediatr. (Rio J.) 91 (6) • Nov-Dec 2015 • https://doi.org/10.1016/j.jped.2015.01.005 copy

Febrile seizures: a population-based study^☆ ☆ Please cite this article as: Dalbem JS, Siqueira HH, Espinosa MM, Alvarenga RP. Febrile seizures: a population-based study. J Pediatr(Rio J). 2015;91:529-34.

Authorship

Abstract

Objectives

To determine the prevalence of benign febrile seizures of childhood and describe the clinical and epidemiological profile of this population.

Methods

This was a population-based, cross-sectional study, carried out in the city of Barra do Bugres, MT, Brazil, from August 2012 to August 2013. Data were collected in two phases. In the first phase, a questionnaire that was previously validated in another Brazilian study was used to identify suspected cases of seizures. In the second phase, a neurological evaluation was performed to confirm diagnosis.

Results

The prevalence was 6.4/1000 inhabitants (95% CI: 3.8-10.1). There was no difference between genders. Simple febrile seizures were found in 88.8% of cases. A family history of febrile seizures in first-degree relatives and history of epilepsy was present in 33.3% and 11.1% of patients, respectively.

Conclusions

The prevalence of febrile seizures in Midwestern Brazil was lower than that found in other Brazilian regions, probably due to the inclusion only of febrile seizures with motor manifestations and differences in socioeconomic factors among the evaluated areas.

KEYWORDS
Prevalence; Febrile seizure; Epidemiology

Variable	Observed frequency (n)	Percentage (%)	95% CI
Gender
Male	9	50.00	(26.02–73.98)
Female	9	50.00	(26.02–73.98)

Ethnicity
White	7	38.89	(17.30–64.25)
Non-white	11	61.11	(35.74–82.70)

Number of seizure episodes
Single episode	16	88.89	(65.29–98.62)
Two episodes	1	5.56	(0.14–27.29)
Three episodes	1	5.56	(0.14–27.29)

Antiepileptic drug used
Phenobarbital	2	11.11	(1.38–34.71)
Valproate	3	16.67	(3.58–41.42)
None	13	72.22	(46.52–90.30)

Type of seizure
Generalized	16	88.89	(65.29–98.62)
Focal	2	11.11	(1.38–34.71)

Risk of miscarriage in pregnancy
Yes	2	11.11	(1.38–34.71)
No	16	88.89	(65.29–98.62)

Received prenatal care (> six consultations)
Yes	18	100	–

Type of delivery
Vaginal	9	50.00	(26.02–73.98)
Cesarian section	9	50.00	(26.02–73.98)

Gestational age
Full-term	17	94.44	(72.71–99.86)
Preterm	1	5.56

Birth weight
2000 g ≤ weight < 2500 g	2	11.11	(1.38–34.71)
2500 g ≤ weight ≤ 3000 g	5	27.78	(9.70–53.48)
Weight > 3000 g	11	61.11	(35.74–82.70)

Apgar>7
Yes	18	100	–

Neonatal complication (infection)
Yes	2	11.11	(1.38–34.71)
No	16	88.89	(65.29–98.62)

Neuropsychomotor development
Normal	18	100	–

Family history of epilepsy
Yes	2	11.11	(1.38–34.71)
No	16	88.89	(65.29–98.62)

Family history of febrile seizure
Yes	6	33.33	(13.34–59.01)
No	12	66.67

Consanguinity
No	18	100	–

Paternal level of schooling
Incomplete Elementary School	9	50.00	(26.02–73.98)
Complete Elementary School	3	16.67	(3.58–41.42)
Incomplete High School	1	5.56	(0.14–27.29)
Complete High School	4	22.22	(6.41–47.64)
College/University	1	5.56	(0.14–27.29)

Maternal level of schooling
Incomplete Elementary School	8	44.44
Complete Elementary School	2	11.11	(1.38–34.71)
Incomplete High School	2	11.11	(1.38–34.71)
Complete High School	5	27.78	(9.69–53.48)
College/University	1	5.56	(0.14–27.29)

Family income
1 MW	7	38.89	(17.30–64.25)
Between 1 and 2 MWs	1	5.56	(0.14–27.29)
2 MW	6	33.33	(13.34–59.01)
>3 MW	4	22.22	(6.41–47.64)

Author/year	Country	Patient recruitment	Mean age at first seizure (months)	Prevalence/1000	Male gender	Family history of febrile seizure	Family history of epilepsy	Simple febrile seizure
Sampaio, 2010¹¹11 Sampaio LP, Caboclo LO, Kuramoto K, Reche A, Yacubian EM, Manreza ML. Prevalence of epilepsy in children from a Brazilian area of high deprivation. Pediatr Neurol. 2010;42:111-117.	Brazil	Cross-sectional (active search)		13.9
Nunes, 2011¹⁵15 Nunes ML, Geib LT, Grupo Apego. Incidence of epilepsy andseizure disorders in childhood and association with social deter-minants: a birth cohort study. J Pediatr (Rio J). 2011;87:50-6.	Brazil	Cohort		16
Al Rajeh, 2001¹³13 Al Rajeh S, Awada A, Bademosi O, Ogunniyi A. The prevalence of epilepsy and other seizure disorders in an Arab population: a community-based study. Seizure. 2001;10:410-414.	Saudi Arabia	Cross-sectional (active search)		3.55
Sfaihi, 2012¹⁶16 Sfaihi L, Maaloul I, Kmiha S, Aloulou H, Chabchoub I, Kamoun T. Febrile seizures: an epidemiological and outcome study of 482 cases. Childs Nerv Syst. 2012;28:1779-1784.	Tunisia	Hospital files			58.7%	14.7%	5.6%	55.2%
Nguefack, 2010¹⁸18 Nguefack S, Ngo Kana CA, Mah E, Kuate Tegueu C, Chiabi A, Fru F. Clinical, etiological, and therapeutic aspects of febrile convulsions. A review of 325 cases in Yaoundé. Arch Pediatr. 2010;17:480-485.	Cameroon	Hospital files	24.6			36.4%		58.7%
Yakinci, 2000¹⁷17 Yakinci C, Kutlu NO, Durmaz Y, Karabiber H, Eğri M. Prevalence of febrile convulsion in 3637 children of primary school age in the province of Malatya, Turkey. J Trop Pediatr. 2000;46:249-250.	Turkey	Cross-sectional	23.0	3.24		37.28%	12.71%	85.6%
Banerjee, 2009¹⁹19 Banerjee TK, Hazra A, Biswas A, Ray J, Roy T, Raut DK. Neurological disorders in children and adolescents. Indian J Pediatr. 2009;76:139-146.	India	Cross-sectional (active search)		1.11				84.7%
Chung, 2006²⁰20 Chung B, Wat LC, Wong V. Febrile seizures in southern Chinese children: incidence and recurrence. Pediatr Neurol. 2006;34:121-126.	China	Hospital files	25			17.5%
Fallah, 2010²¹21 Fallah R, Karbasi SA. Recurrence of febrile seizure in Yazd, Iran. Turk J Pediatr. 2010;52:618-622.	Iran	Hospital files	24					67%
Verity, 1985²²22 Verity CM, Butler NR, Golding J. Febrile convulsions in a national cohort followed up from birth. I – Prevalence and recurrence in the first five years of life. Br Med J (Clin Res Ed). 1985;290:1307-1310.	England	Cohort	24			16.2%	7.5%	76.9%
Sillanpää, 2008²⁷27 Sillanpää M, Camfield P, Camfield C, Haataja L, Aromaa M, Helenius H. Incidence of febrile seizures in Finland: prospective population-based study. Pediatr Neurol. 2008;38:391-394.	Finland	Cohort
Aydin, 2008²⁸28 Aydin A, Ergor A, Ozkan H. Effects of sociodemographic factors on febrile convulsion prevalence. Pediatr Int. 2008;50:216-220.	Turkey	Cross-sectional, schoolchildren				15–17.3%

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E-mail: jped@jped.com.br

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[1] * Corresponding author. E-mail: jsdalbem@hotmail.com (J.S. Dalbem).

Name:	Age:
Number of children in the household up to 19 years:	Age:
1. Have the children/adolescents up to 19 years in your home had (or still have) seizures (fits, convulsions) in which they lost consciousness and fell down suddenly?	Yes ( )	No ( )
2. Have the children/adolescents up to 19 years in your home had (or still have) seizures in which they has lost touch with reality and was “disconnected"?	Yes ( )	No ( )
3. Have the children/adolescents up to 19 years in your home had (or still have) seizures in which they had sudden/abrupt movements of the arms, legs, or mouth, or turned their head to the side?	Yes ( )	No ( )
4. Have the children/adolescents up to 19 years in your home had (or still have) episode (s) of fainting and after they regained consciousness, you realized they had urinated or defecated on their clothes by accident?	Yes ( )	No ( )
5. Have the children/adolescents up to 19 years of your home had (or still have) seizures in which they had a bad feeling such as a “hunch" or a “knot" in the stomach that rose to the throat, after which he or she fell unconscious? Can the person who witnessed it say whether they was touching the clothes, chewing, or staring at a distant point?	Yes ( )	No ( )
6. Has a doctor or health care professional or even family members ever mentioned that the child in your home had febrile seizures in childhood or during any severe illness?	Yes ( )	No ( )
7. Have the children/adolescents up to 19 years in your home had (or still have) sudden movements similar to a “shock" in the arms (he or she dropped things) or legs, with or without falls, especially during the morning?	Yes ( )	No ( )
8. Have the children/adolescents up to 19 years in your home who have epilepsy been admitted to a hospital in Mato Grosso before?	Yes ( )	No ( )
In case of any affirmative answer, refer the child/adolescent for consultation.	Yes ( )	No ( )

Brasil

Brasil

Febrile seizures: a population-based study☆ ☆ Please cite this article as: Dalbem JS, Siqueira HH, Espinosa MM, Alvarenga RP. Febrile seizures: a population-based study. J Pediatr(Rio J). 2015;91:529-34.

Abstract

Objectives

Methods

Results

Conclusions

Febrile seizures: a population-based study^☆ ☆ Please cite this article as: Dalbem JS, Siqueira HH, Espinosa MM, Alvarenga RP. Febrile seizures: a population-based study. J Pediatr(Rio J). 2015;91:529-34.