Clinical Characteristics and Risk Factors for a Complex First Febrile Convulsion

SG Ling
Correspondence: Dr S G Ling

ABSTRACT
Objectives To determine the frequency of complex features in febrile convulsion, association of complex febrile convulsion with neurological findings and risk factors associated with complex febrile convulsion.
Methodology Retrospective review of clinical records of 379 patients admitted for their first febrile convulsion over a two-year period.
Results Complex features occurred in 37.2% patients. Focal seizures tended to be prolonged as well. There was also significant association between prolonged or focal seizures with presence of neurological abnormalities. The longer the duration of the seizure, the higher was the likelihood of neurological abnormalities. Risk factors associated with a complex first febrile convulsion were: 1) Age of 15 months or less, 2) Birth weight of 2 kg or less and 3) initial temperature of 38 degrees C or less.
Conclusion Any acute febrile convulsion should be abbreviated soonest possible as neurological abnormalities, which may be signs of cerebral insult become more likely with increasing duration of seizures. The risk factors found associated with complex febrile convulsion underline the propensity of the immature, developing brain to abnormal seizure discharges in response to a lower temperature threshold.

Keywords: complex febrile seizure, risk factors, neurological abnormalities
Singapore Med J 2001; 42(6): 264-267