title: Afebrile seizure subsequent to initial febrile seizure.
abstract: BACKGROUND
  Febrile seizure (FS) is the most common paediatric neurological problem. The purpose of this study was to determine the frequency of afebrile seizures subsequent to FS in children with initial FS and to evaluate its risk factors.
  
  
  METHODS
  A prospective study was conducted on all children (age 6 months to 6 years) referred with initial FS to the Shahid Sadoughi Hospital, Yazd, Iran, between August 2004 and March 2006, who were followed up for at least 15 months for the occurrence of subsequent afebrile seizures.
  
  
  RESULTS
  161 boys and 120 girls (mean age 2.12 ± 1.33 years) were followed up for 34.1 ± 7.8 months. 87 (31%) patients had complex FS and 19 (6.7%) patients had subsequent afebrile seizure, with a mean occurrence time of 10.6 ± 6.4 months. Univariate analysis using chi-square test showed that initial FS within one hour of developing fever (p = 0.0001), neurodevelopmental delay (p = 0.0001), family history of epilepsy (p = 0.0001), recurrent FS (p = 0.003) and focal FS (p = 0.04) were risk factors for subsequent afebrile seizure. On multivariate analysis, neurodevelopmental delay (odds ratio [OR] 2.6, 95% confidence interval [CI] 2.3-3.4), initial FS within one hour of developing fever (OR 1.7, 95% CI 1.2-2.1) and family history of epilepsy (OR 1.5, 95% CI 1.1-1.9) were significant factors.
  
  
  CONCLUSIONS
  Special attention should be paid to children with FS during history-taking and developmental assessments to identify high-risk patients and those who might need prophylactic anticonvulsants.
authors.affiliation: Department of Paediatrics, University of Medical Sciences, Yazd, Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Fallah
authors.forename: Fallah
authors.initials: F
authors.lastname: Razieh
authors.forename: Sedighah
authors.initials: S
authors.lastname: Akhavan Karbasi
authors.forename: Akhavan Karbasi
authors.initials: AK
authors.lastname: Sedighah
authors.forename: Motahhareh
authors.initials: M
authors.lastname: Golestan
authors.forename: Golestan
authors.initials: G
authors.lastname: Motahhareh
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology*; D003294:Seizures, Febrile / Q000453:epidemiology*