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J Korean Child Neurol Soc. 2017 Dec;25(4):215-220. English. Multicenter Study.
Baek J , Hwang SY , Byeon JH , Eun SH , Eun BL , Kim GH .
Department of Pediatrics, Korea University Guro Medical Center, Seoul, Korea.,
Biostatistical Consulting lab, Medical Science Research Center, Korea University College of Medicine, Seoul, Korea.
Department of Pediatrics, Korea University Anam Medical Center, Seoul, Korea.
Department of Pediatrics, Korea University Ansan Medical Center, Gyeonggi-do, Korea.


There is a paucity of evidence about prognosis after a first febrile seizure in older children. We investigated the prognosis and potential risk factors associated with subsequent unprovoked seizures in children who had experienced a first febrile seizure over 6 years of age, which we termed as late-onset febrile seizure.


We included all patients six years or older who presented to the emergency department with a febrile seizure between 2009 and 2015. Clinical data was collected by chart review and parents were contacted for information on seizure progress. We used the Cox proportional-hazards model and Kaplan-Meier analysis for evaluating the risk factors for subsequent unprovoked seizures.


Of 247 patients, we excluded 168 children who had a history of epilepsy, unprovoked, or febrile seizure and who were followed-up for period less than six months. Overall, 79 patients were classified as having had a first late-onset febrile seizure. During follow-up of 34.9±25.7(mean±SD) months, unprovoked seizure recurred in 7 of 79 patients (9%). The cumulative probability of seizure recurrence was 4% at 6 months, 6% at 1 year and 9% at 2 years. Clinical variables predictive of subsequent unprovoked seizures were not proved.


This is the first multicenter study focusing on prognosis after a late-onset febrile seizure in children six years or older. The percentage of subsequent unprovoked seizure in patients with late-onset febrile seizure was 9% at 2 years of follow-up. Prospective follow-up study with longer duration is warranted.

Copyright © 2019. Korean Association of Medical Journal Editors.