Predictors of recurrent febrile seizures: A prospective cohort study

Anne T. Berg*, Shlomo Shinnar, Amy S. Darefsky, Theodore R. Holford, Eugene D. Shapiro, Morton E. Salomon, Ellen F. Crain, Allen W. Hauser

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

183 Scopus citations


Objectives: To define the risk and identify predictors of single and multiple recurrent febrile seizures. Methods: Children (n=428) with first febrile seizures were prospectively identified and followed for 2 or more years. Parents were interviewed soon after their children's first febrile seizure and were called every 3 months to ascertain recurrent febrile seizures. Medical records of first and recurrent seizures were reviewed for additional information. Results: A total of 136 children (31.8%) experienced recurrent seizures: 73 (17.1%) had only 1 recurrence, 38 (8.9%) had 2 recurrences, and 25 (5.8%) had 3 or more recurrences. Young age at onset, a history of febrile seizures in a first-degree relative, low degree of fever while in the emergency department, and a brief duration between the onset of fever and the initial seizure were strong independent predictors of recurrent febrile seizures. With these 4 factors combined, it is possible to define groups of children having very high and very low probabilities of having any recurrences (>70% vs <20%), having 2 or more recurrences (>60% vs <10%), and having 3 or more recurrences (12% vs about 0%). In children who had at least 1 recurrence, age at the time of the first recurrence and a family history of epilepsy were predictors of subsequent recurrences. Conclusions: In children who have had a first febrile seizure, recurrences are common. The risk for 1 or more recurrences can be meaningfully predicted at the time of the initial febrile seizure with a combination of the 4 factors identified in this study.

Original languageEnglish (US)
Pages (from-to)371-378
Number of pages8
JournalArchives of Pediatrics and Adolescent Medicine
Issue number4
StatePublished - Apr 1997

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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