Clinical Profile and Predictors of Recurrent Simple Febrile Seizure

Background Recurrent simple febrile seizure (SFS) refers to febrile seizures (FS) that recur within 24 hours. Patients with recurrent SFS often undergo unnecessary neurodiagnostic tests. To address this, we compared the clinical characteristics of recurrent SFS with those of SFS and investigated the risk factors associated with recurrent SFS. Methods We retrospectively reviewed electronic medical records of patients aged 6-60 months who had been hospitalized for FS at two training hospitals between January 2016 and December 2019. The primary outcome was a comparison of the clinical features of patients with SFS and recurrent SFS. Additionally, the risk factors associated with seizure recurrence within 24 hours were evaluated. Results Three-quarters (n=191, 75.2%) of the 254 enrolled patients experienced a single seizure episode during the febrile illness period. The remaining 63 patients (24.8%) were diagnosed as recurrent SFS. Significant differences between SFS and recurrent SFS were observed in the history of recurrent SFS, time from fever onset to seizure, and body temperature on hospital arrival. Multiple logistic regression analysis revealed that a history of previous recurrent SFS (odds ratio [OR] 10.161) and a body temperature below 39 °C on arrival (OR 2.377) were significantly associated with early seizure recurrence. Conclusion This study highlights that early FS recurrence is common and has a self-limiting clinical course similar to that of SFS. We recommend close monitoring of the patient for 6–8 hours when a history of early recurrence is present or if the seizure occurs at a low body temperature.