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J Korean Child Neurol Soc. 1998 Oct;6(1):91-97. Korean. Original Article.
Choi BJ , Lee IG , Whang KT .
Department of Pediatrics, Catholic University Medical College, Seoul, Korea.
Abstract

PURPOSE: Febrile convulsion is a common clinical problem affecting 2-4 percent of children. The recurrence rate of FC is a approximately 33-50%. To identify factors influencing the recurrences of febrile convulsions, we investigated the risk factors, especially the relationship between the degree of pyrexia at the initial febrile seizure and the likelihood of subsequent febrile fits. METHODS: During the 24 months, we reviewed the children who presented their first febrile convulsion. All were admitted to the hospital for investigation and treatment. The study group compromised 136 children. A febrile convulsion was defined as a generalized convulsion that occurred within 15 minutes in a child aged 6 months to 5 years who had no pre-existing evidence of neurological abnormalities. The children were divided into three groups according to the severity of the fever recorded on presentation to hospital. Group I had temperatures higher than 39.5degrees C, group II, 38.5-39.4degrees C, and group III lower than 38.4degrees C. RESULTS: 1) 17 (40.5%) children had recurrences with a positive family history in first-degree relatives, 12 (60.0%) of febrile convulsions, 3 (42.9%) of epilepsy and 2 (66.7%) of febrile convulsions and epilepsy.2) In group I, three (15.8%) infants aged 6-18 months and two (13.3%) aged 19-30 months had recurrences of febrile convulsions. In group II, 13 (36.1%) infants aged 6-18 months and 5 (23.8%) aged 19-30 months had recurrences of febrile convulsions. In group III, 10 (41.7%) infants aged 6-18 months and 6 (46.2%) aged 19-30 months had recurrences of febrile convulsions.3) The overall recurrence after the initial febrile convulsion was 22 (52.4%) children by 6 months, 34 (81.0%) children by 12 months, 39 (92.9%) children by 18 months, and 42(100%) by 24 months.4) Fifteen (42.9%) had the recurrences between 6 and 12 months of age at initial febrile convulsion, 21(27.6%) between 13 and 24 months, and 4 (18.2%) between 25 and 36 months. CONCLUSION: Early age at onset of first febrile convulsion, a history of febrile convulsions in first-degree relatives were associated with an increased risk of recurrent febrile convulsions. Especially children with the lower degree of pyrexia at the time of the initial convulsion were more susceptible to recurrent convulsions than those with higher levels of pyrexia.

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