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Febrile seizures: factors affecting risk of recurrence in Pakistani children presenting at the Aga Khan University Hospital.

OBJECTIVES
To (a) describe the effect of temperature rise on seizure recurrence in the ER (b) investigate the effect of age, gender, family and developmental history, type, duration and multiple seizures, past history and number of seizures and treatment given (either late or early) on seizure recurrence in the ER and (c) explore prognostic indicators for seizure recurrence.


METHODS
Data from 352 children [ages 3-84 months; 220 males (62.5%) 132 females (37.5%)] was taken using chart reviews for the years January 1998-August 2000 inclusive, from the Pediatric department of the Aga Khan University Hospital. Descriptive statistics, Chi-square, and Discriminant Analysis were used.


RESULTS
Of the 52 (16%) cases that had seizure recurrence in the ER, majority (36.5%) occurred in > 38.5 degrees < or = 39.5 degrees C temperature range. The percentage declined to 15% at higher temperatures. Bivariate tests showed that age, family and developmental history, type of seizure and treatment given did not affect seizure recurrence in the ER. Past history number of seizures (p = .006), duration of seizure (p < 0.001), past history of seizures (p = 0.004) and multiple seizure (p = 0.024) were factors significantly associated with seizure recurrence in the ER at the bivariate level of analysis. Duration of seizure was the most important prognostic indicator for FS recurrence in the ER at the multivariate level with beta = .79.


CONCLUSION
Duration of seizure (> 5 minutes) was the most important prognostic factor for FS recurrence. Early treatment did not affect recurrence,suggesting timely anti-pyretic vs. anti-leptic medication use.