Prognosis

Prognosis is generally favourable.[99][100]

Febrile seizures recur in approximately 30% of children during subsequent febrile illnesses.[95] Most recurrences occur within 2 years. The risk of non-febrile seizures and epilepsy developing after simple febrile seizures is 5% or less. However, after complex febrile seizures, the risk of developing epilepsy is 10% to 20%.[101] Febrile seizures are not associated with sudden unexpected death in epilepsy.[101][102] Epidemiological data indicate that the vast majority of children with febrile seizures have a normal long-term outcome.[6][103]

Genetic studies suggest that the relationship between febrile seizures and subsequent epilepsy and neurocognitive dysfunction is sometimes genetic, but there are complex interactions between genetic and environmental modifiers.[104]

Hippocampal abnormalities (mesial temporal sclerosis) and focal epilepsy are sometimes associated with prolonged febrile seizures.[66] Magnetic resonance imaging-detected brain abnormalities have also been reported in children following simple febrile seizures, and in adults with a history of simple febrile seizures in childhood.[105][106] Therefore, febrile seizures may be less benign than generally thought.

The literature appears to support a role for febrile status in the development of focal epilepsy, but febrile status is clearly neither necessary nor sufficient on its own in the focal epileptogenesis process. Multiple insults are likely necessary for a child with febrile status epilepticus to develop epilepsy later in life.[107]

One study has shown that children who have febrile seizures are at a higher risk of developing psychiatric disorders in later life.[108]

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