American Journal of Epidemiology Advance Access published online on January 30, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwk086
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ORIGINAL CONTRIBUTION |
The Long-Term Risk of Epilepsy after Febrile Seizures in Susceptible Subgroups
1 Department of General Practice, Institute of Public Health, Aarhus University, Aarhus, Denmark
2 Department of Epidemiology, Institute of Public Health, Aarhus University, Aarhus, Denmark
3 National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
4 Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
5 Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA
6 Department of Clinical Pharmacology, Aarhus University, Aarhus, Denmark
Correspondence to Dr. Mogens Vestergaard, Department of General Practice, Institute of Public Health, Aarhus University, Vennelyst Boulevard 6, DK-8000 Aarhus C, Denmark (e-mail: mv{at}soci.au.dk).
A family history of seizures, preexisting brain damage, or birth complications may modify the long-term risk of epilepsy after febrile seizures. The authors evaluated the association between febrile seizures and epilepsy in a population-based cohort of 1.54 million persons born in Denmark (1978–2002), including 49,857 persons with febrile seizures and 16,481 persons with epilepsy. Overall, for children with febrile seizures compared with those without such seizures, the rate ratio for epilepsy was 5.43 (95% confidence interval: 5.19, 5.69). The risk remained high during the entire follow-up but was particularly high shortly after the first febrile seizure, especially in children who experienced early (<1 year of age) or late (>3 years of age) onset of febrile seizures. At 23 years of follow-up, the overall cumulative incidence of epilepsy after febrile seizures was 6.9% (95% confidence interval: 6.5, 7.3). In conclusion, persons with a history of febrile seizures had a higher rate of epilepsy that lasted into adult life, but less than 7 percent of children with febrile seizures developed epilepsy during 23 years of follow-up. The risk was higher for those who had a family history of epilepsy, cerebral palsy, or low Apgar scores at 5 minutes.
Apgar score; birth weight; cerebral palsy; Denmark; epilepsy; follow-up studies; premature birth; seizures, febrile
Abbreviations: CI, confidence interval; ICD-8, International Classification of Diseases, Eighth Revision; ICD-10, International Classification of Diseases, Tenth Revision
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