Evaluation of Risk Factors Associated with First Febrile Seizure: A Hospital Based Case-Control Study

Introduction:
Febrile seizures (FS) are the most prevalent type of seizures seen in
paediatric practice, yet the underlying causes remain poorly understood.
Objective:
This study aimed to identify risk factors associated with the first febrile
seizure in children aged 6 months to 5 years.
Methods:
This hospital-based case-control study was conducted from January to
December 2024 at the Paediatrics Department of Jalalabad
Ragib-Rabeya Medical College Hospital in Sylhet including 200
children aged 6 months to 5 years, with 100 cases admitted for their first
febrile seizure and 100 controls admitted for fever without a history of
seizures. Data were collected using a pre-designed semi-structured
questionnaire and statistical analyses, including the Chi-square test,
Student’s t-test and odds ratio calculations were performed to compare
risk factors between the two groups.
Results:
The mean age of children in the case vs control group was insignificant
(17.17±8.22 vs 18.89±14.83 months; p=0.3116). However, boys
exhibited a significantly higher risk of developing FS, with the odds of
boys experiencing FS being twice that of girls (95% CI=1.1578 to
3.6980, p=0.0141). A family history of febrile seizures was notably
linked to the occurrence of first febrile seizure, with eight times greater
odds for affected children (95% CI=3.355 to 21.209, p<0.0001). There
was no significant correlation identified between a family history of
epilepsy and the first febrile seizure. Children who were exclusively
breastfed had a lower susceptibility to febrile seizures (OR=0.409, 95%
CI=0.1924 to 0.8090, p=0.0202). Antenatal and perinatal complications
were significantly higher in the case group than the control group
(p<0.05). The mean admission temperature for cases was significantly
higher at 100.92±1.540
F compared to 100.28±1.460
F in controls
(p=0.0029). Upper respiratory tract infections (URTI) emerged as the
most common trigger for febrile seizures (p< 0.001) and serum sodium
levels were significantly lower while serum calcium and random blood
sugar levels were significantly higher in the case group (p<0.05).
Conclusion:
Male gender, positive family history of febrile seizures, inadequate
exclusive breastfeeding, elevated body temperature, antenatal and perinatal
complications, upper respiratory tract infections as well as abnormal serum
sodium, calcium, and blood sugar levels were significant risk factors for the
first episode of febrile seizure. Addressing and mitigating these risk factors
could significantly reduce the incidence of febrile seizures in children.