Febrile Seizures and Sudden Death Risk: A Case-Control Analysis

IF 2.1 3区 医学 Q2 CLINICAL NEUROLOGY
Laura Gould MSc , Steven Friedman MS , Thomas Wisniewski MD , Orrin Devinsky MD
{"title":"Febrile Seizures and Sudden Death Risk: A Case-Control Analysis","authors":"Laura Gould MSc ,&nbsp;Steven Friedman MS ,&nbsp;Thomas Wisniewski MD ,&nbsp;Orrin Devinsky MD","doi":"10.1016/j.pediatrneurol.2025.06.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Febrile seizures occur in 3%-4% of US children aged six months to five years and are considered benign. However, sudden unexplained death in childhood is associated with 10 times increase in febrile seizures. We assessed the characteristics of children with febrile seizure and sudden death to identify factors that confer increased sudden death risk.</div></div><div><h3>Methods</h3><div>We conducted a case-control analysis of children with febrile seizure and subsequent sudden death versus living controls from December 2021 to June 2023 through an ∼10-minute anonymous online survey. We enrolled parents of children, living or deceased, whose child had experienced a febrile seizure from age six months to six years. Subjects were excluded if the child had an afebrile seizure or parents had not witnessed a febrile seizure. Demographic characteristics, parasomnias, and febrile seizure features were analyzed.</div></div><div><h3>Results</h3><div>A total of 381 completed surveys were received; 53 (14%) cases of febrile seizure with sudden death and 328 (86%) living controls. Cases reported febrile seizure onset &gt;2 months earlier (<em>P</em> = 0.013) and reported developmental concerns (odds ratio [OR] = 2.32, 95% confidence interval [CI] [1.14, 4.71], <em>P</em> = 0.03), less frequent night awakenings (OR = 0.34, 95% CI [0.18, 0.65], <em>P</em> = 0.001), and less restless sleep (OR = 0.37, 95% CI [0.16, 0.85], <em>P</em> = 0.02). Cases were also less likely to drool (OR = 0.442, 95% CI [0.218, 0.900], <em>P</em> = 0.032) or be unresponsive for more than one minute (OR = 0.45, 95% CI [0.238, 0.854], <em>P</em> = 0.021).</div></div><div><h3>Conclusions</h3><div>We report novel associations of febrile seizure and sudden death related to age, development, sleep, and observed ictal features. Anonymous survey methodology cannot exclude ascertainment bias and any related potential effect on results. Our findings suggest that impaired arousal mechanisms may increase risk of death in subjects with febrile seizure.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"170 ","pages":"Pages 26-30"},"PeriodicalIF":2.1000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric neurology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0887899425001705","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Febrile seizures occur in 3%-4% of US children aged six months to five years and are considered benign. However, sudden unexplained death in childhood is associated with 10 times increase in febrile seizures. We assessed the characteristics of children with febrile seizure and sudden death to identify factors that confer increased sudden death risk.

Methods

We conducted a case-control analysis of children with febrile seizure and subsequent sudden death versus living controls from December 2021 to June 2023 through an ∼10-minute anonymous online survey. We enrolled parents of children, living or deceased, whose child had experienced a febrile seizure from age six months to six years. Subjects were excluded if the child had an afebrile seizure or parents had not witnessed a febrile seizure. Demographic characteristics, parasomnias, and febrile seizure features were analyzed.

Results

A total of 381 completed surveys were received; 53 (14%) cases of febrile seizure with sudden death and 328 (86%) living controls. Cases reported febrile seizure onset >2 months earlier (P = 0.013) and reported developmental concerns (odds ratio [OR] = 2.32, 95% confidence interval [CI] [1.14, 4.71], P = 0.03), less frequent night awakenings (OR = 0.34, 95% CI [0.18, 0.65], P = 0.001), and less restless sleep (OR = 0.37, 95% CI [0.16, 0.85], P = 0.02). Cases were also less likely to drool (OR = 0.442, 95% CI [0.218, 0.900], P = 0.032) or be unresponsive for more than one minute (OR = 0.45, 95% CI [0.238, 0.854], P = 0.021).

Conclusions

We report novel associations of febrile seizure and sudden death related to age, development, sleep, and observed ictal features. Anonymous survey methodology cannot exclude ascertainment bias and any related potential effect on results. Our findings suggest that impaired arousal mechanisms may increase risk of death in subjects with febrile seizure.
热性惊厥与猝死风险:病例-对照分析
背景:在6个月至5岁的美国儿童中,有3%-4%的儿童发生发热性癫痫发作,并且被认为是良性的。然而,儿童期不明原因的猝死与热性惊厥增加10倍有关。我们评估了热性惊厥和猝死儿童的特征,以确定导致猝死风险增加的因素。方法通过一项10分钟的匿名在线调查,对2021年12月至2023年6月期间发生热性惊厥并随后猝死的儿童与活着的对照组进行病例对照分析。我们招募了孩子的父母,活着的或死去的,他们的孩子从6个月到6岁经历过热性癫痫发作。如果儿童有发热性发作或父母没有目睹发热性发作,受试者被排除在外。分析人口学特征、睡眠异常和热性惊厥特征。结果共收到调查问卷381份;53例(14%)发热性惊厥并发猝死,328例(86%)存活对照。病例报告发热性癫痫发作早2个月(P = 0.013),并报告有发育问题(优势比[OR] = 2.32, 95%可信区间[CI] [1.14, 4.71], P = 0.03),夜间醒来次数减少(OR = 0.34, 95% CI [0.18, 0.65], P = 0.001),不安稳睡眠减少(OR = 0.37, 95% CI [0.16, 0.85], P = 0.02)。患者流口水的可能性也更小(OR = 0.442, 95% CI [0.218, 0.900], P = 0.032)或无反应超过1分钟(OR = 0.45, 95% CI [0.238, 0.854], P = 0.021)。结论:我们报告了与年龄、发育、睡眠和观察到的体征特征有关的热性惊厥和猝死的新关联。匿名调查方法不能排除确定偏差和对结果的任何相关潜在影响。我们的研究结果表明,觉醒机制受损可能会增加热性惊厥患者的死亡风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Pediatric neurology
Pediatric neurology 医学-临床神经学
CiteScore
4.80
自引率
2.60%
发文量
176
审稿时长
78 days
期刊介绍: Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信