Febrile seizures occur in as many as 5% of children before age 5 years, and parents often are fearful about subsequent risk for death. Danish investigators used a national registry to assess this risk in 1,675,643 children whose medical status was followed for as long as 28 years (mean, 13 years); 55,215 children had first febrile seizures between ages 3 months and 5 years.
Risk for death was significantly higher during the first 2 years after a first febrile seizure (mortality rate ratio [MRR], 1.73). However, this higher risk was attributable to subgroups of children who had underlying neurologic abnormalities; complex seizures (>15 minutes or recurrence within 24 hours; MRR, 1.99); seizures triggered by a temperature lower than 39°C (MRR, 2.26); or febrile seizures before age 1 year (MRR, 1.84). In contrast, the mortality rate among children with simple febrile seizures (
15 minutes, without recurrence within 24 hours) was similar to the rate in the general population.Comment: These reassuring results indicate that simple febrile seizures that are not associated with underlying neurologic abnormalities or other high-risk features do not increase risk for death in children. The results also do not support the hypothesis that febrile seizures and sudden infant death syndrome are linked.
— Thomas L. Schwenk, MD
Published in Journal Watch General Medicine August 14, 2008