Risk of epilepsy in pediatric patients with febrile seizures: Insights from nationwide registry data in Korea

Abstract

Purpose

The incidence of epilepsy following febrile seizures (FS) is estimated at 2 %–7 %. Early identification of children at risk of epilepsy could have clinical implications, as these children may require special attention. This study investigated epilepsy incidence in children with FS and identified risk factors that increase the likelihood of developing epilepsy in Korea.

Methods

This nationwide, population-based study used data from the Korean Health Insurance Review and Assessment Service database. Patients aged 6 months to <6 years at their first visit between January 2010 and June 2013 with primary, secondary, or additional FS diagnostic codes were selected. Patient demographics, diagnostic codes, and prescriptions were retrieved from the database.

Results

A total of 130,248 patients diagnosed with FS were identified. During a median follow-up period of 11.8 years (interquartile range, 11.0–12.8), 3,047 patients (2.3 %) were subsequently diagnosed with epilepsy, while 127,201 patients (97.7 %) did not develop epilepsy. A higher number of FS episodes (2 episodes, odds ratio (OR) 1.61; 3 episodes, OR 2.17; 4 episodes, OR 2.40; 5+ episodes, OR 4.85) and prolonged FS (OR 25.82) were associated with increased epilepsy risk (p < 0.05). Epilepsy was most common during toddler and preschool years (2,049/3,047, 67.2 %), while it was relatively low during adolescence (141/3,047, 4.6 %).

Conclusion

Recognizing the risk factors and age distribution of epilepsy onset can assist clinicians in identifying children at high risk early, facilitating targeted monitoring and timely intervention. This approach may ultimately reduce unnecessary investigations and optimize follow-up for children with FS.