Which feature in a child with febrile seizures confers the highest risk of later developing epilepsy?

• A Family history of febrile seizures in a sibling
• B Age younger than 12 months at first febrile seizure
• C Male sex
• D Febrile status epilepticus lasting more than 30 minutes ✓

Explanation

Prolonged febrile seizures, particularly febrile status epilepticus beyond 30 minutes, carry the highest risk of subsequent epilepsy, partly through mesial temporal sclerosis after injury to the hippocampus. A family history of febrile seizures predicts recurrence of febrile seizures rather than epilepsy, young age at onset raises recurrence risk only modestly, and male sex is a weak demographic factor. Simple febrile seizures carry an epilepsy risk barely above the background population rate of about 1 percent.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.