A 2-year-old presents with fever 39.8°C and a 3-minute generalized tonic-clonic seizure, now fully conscious. This is his first febrile seizure. He recovers completely. Which of the following is the BEST predictor of RECURRENCE of febrile seizures?
- A Seizure duration > 2 minutes
- B Age < 18 months at first febrile seizure ✓
- C Temperature > 40°C at time of seizure
- D Focal onset rather than generalized onset
Correct answer: B. Age < 18 months at first febrile seizure
Explanation
The strongest predictor of febrile seizure recurrence is young age at first febrile seizure (<18 months, or especially <12 months). Additional risk factors include family history of febrile seizures, low-grade fever at the time of seizure (lower threshold), and family history of epilepsy. Recurrence rate overall is ~30–35%; with age <12 months it approaches 50–65%. Duration > 2 minutes and temperature at seizure onset are not reliable predictors of recurrence. Focal febrile seizures are a risk factor for epilepsy development, not specifically recurrence of febrile seizures.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.