Clinical Spectrum and Outcomes of Febrile Seizures in Children: A Retrospective Study

Abstract

Febrile seizures are the most common seizure disorder in children, typically presenting between 6 months and 5 years of age. Objective: To assess the clinical spectrum, associated factors, and outcomes of febrile seizures in children. Methodology: This was a hospital-based retrospective analytical study conducted at Paediatrics Department of Shahida Islam Teaching Hospital Lodhran from June, 2025 to September, 2025, including 255 pediatric patients who presented with febrile seizures. Results: The mean age was 24.6 ± 13.2 months, with complex febrile seizures occurring at a younger age (19.8 ± 12.7 vs 26.8 ± 12.9 months, p = 0.002). Complex seizures were associated with longer duration (15.6 ± 7.8 vs 4.2 ± 2.1 minutes), higher frequency of multiple episodes (59.7% vs 15.7%), and increased focal features (48.1% vs 6.7%) (p <0.001). Family history of febrile seizures (46.8% vs 23.6%) and epilepsy (20.8% vs 9.0%) were significantly higher in complex cases. Recurrence was observed in 32.2% of patients and was more frequent in patients with complex seizures (49.4% vs 24.7%, p < 0.001). Development of epilepsy occurred in 7.1% of cases, predominantly in complex febrile seizures (15.6% vs 3.4%). Longer hospital stay (3.8 ± 1.6 vs 2.1 ± 1.0 days), increased ICU admissions (13.0% vs 2.2%), and neurological deficits (6.5% vs 0.6%) were also associated with complex seizures. Conclusion: Febrile seizures generally have a favorable prognosis; however, complex febrile seizures are associated with higher recurrence, increased risk of epilepsy, and greater healthcare burden. Early identification of high-risk factors is essential for improved management and counseling.