familial febrile seizures 1

Familial Febrile Seizures: An Overview

Febrile seizures are a common occurrence in children, but did you know that they can also run in families? Familial febrile seizures refer to the tendency for febrile seizures to occur within families. Research suggests that if a child's parents, brothers or sisters, or other close relatives have had febrile seizures, the child is more likely to experience them as well.

Prevalence and Risk Factors

Studies indicate that approximately 2% to 5% of all children (2 to 5 out of 100 children) experience febrile seizures. There is a slight tendency for these seizures to run in families, with a higher risk if there is a family history of febrile seizures.

Genetic Link

Research has identified a genetic link between familial febrile seizures and certain underlying conditions. For example, Genetic Epilepsy with Febrile Seizures Plus (GEFS+) is an unusual epilepsy syndrome that often affects multiple members of the same family.

Risk Factors for Recurrent Febrile Seizures

A study found that recurrent febrile seizures were significantly associated with a first-degree family history of febrile seizures. Additionally, later occurrence of afebrile seizures was independently associated with recurrent febrile seizures.

Conclusion

Familial febrile seizures are a relatively common phenomenon, and research has shed light on the genetic and familial factors that contribute to their occurrence. If you have concerns about your child's risk for febrile seizures or if they experience recurring episodes, it is essential to consult with a healthcare professional for personalized guidance.

References:

• [2] Children aged 3 months to 5 or 6 years may have seizures when they have a high fever.
• [6] There is a slight tendency for them to run in families. If a child's parents, brothers or sisters, or other close relatives have had febrile seizures, the child is more likely to experience them as well.
• [15] Recurrent febrile seizures was the only phenotypic feature significantly associated with first-degree family history of febrile seizures (OR 2.1, 95% CI 1.15 to 3.88).

Familial Febrile Seizures: Signs and Symptoms

Children who are prone to febrile seizures due to a family history may exhibit certain signs and symptoms that can indicate an increased risk. These include:

• Family History: Children whose parents, brothers or sisters, or other close relatives have had febrile seizures are more likely to experience them themselves [3][7].
• Multiple Seizures: Family history can also increase the likelihood of having multiple febrile seizures [7].
• Initial Rapid Rise in Body Temperature: Febrile seizures often occur during the initial rapid rise in body temperature, which can be a sign that the child is more susceptible to these episodes [11].

It's essential for parents and caregivers to be aware of these signs and symptoms, especially if there is a family history of febrile seizures. If you suspect your child may be at risk, consult with a healthcare professional for guidance on how to manage this condition.

References: [3] - Children whose family members had febrile seizures are more likely to have more than one seizure. [7] - Family history—Children whose family members had febrile seizures are more likely to have more than one seizure. [11] - Symptoms and Signs of Febrile Seizures. Often, febrile seizures occur during the initial rapid rise in body temperature...

Diagnostic Tests for Familial Febrile Seizures Plus (GEFS+)

Familial febrile seizures plus, also known as Generalized Epilepsy with Febrile Seizures Plus (GEFS+), is a rare genetic disorder characterized by febrile seizures that persist beyond the typical age range. Diagnostic testing for GEFS+ involves a combination of clinical evaluation and laboratory tests.

Clinical Evaluation

A healthcare provider will review a child's medical history and perform a physical examination to diagnose febrile seizures (1). This includes assessing the child's overall health, vaccination status, and any underlying medical conditions that may contribute to febrile seizures.

Laboratory Tests

If necessary, laboratory tests may be performed to rule out other conditions that can cause febrile seizures. These tests include:

• Electroencephalography (EEG): An EEG measures brain waves to assess the risk of seizure recurrence and identify any abnormal electrical activity in the brain (6, 9).
• Genetic testing: Genetic testing may be performed on blood or a cheek swab to confirm the diagnosis of GEFS+ (5, 8). This can involve an epilepsy panel or whole exome sequencing.
• Brain scans: A CT scan or other imaging tests may be ordered to rule out any underlying brain abnormalities that could contribute to febrile seizures (9).

Diagnostic Criteria

GEFS+ is diagnosed clinically through the seizure type, EEG pattern, and family history (7). Molecular genetic testing can confirm the diagnosis.

References

• [1] Nov 22, 2024 — To diagnose a febrile seizure, a healthcare provider will review a child's medical history and do a physical exam.
• [5] Dec 22, 2020 — If done, genetic testing could be performed on blood or a cheek swab. Your doctor may send either an epilepsy panel or whole exome sequencing.
• [6] Electroencephalography (EEG) is done if febrile seizures have focal features or are recurrent. A diagnostic evaluation based on the underlying disorder is done ...
• [7] GEFS+ is diagnosed clinically through the seizure type, EEG pattern, and family history. Molecular genetic testing can confirm the diagnosis.
• [8] Clinical Genetic Test offered by Genome Diagnostics Laboratory for conditions (22): Generalized epilepsy with febrile seizures plus, type 1; ...
• [9] Electroencephalogram (EEG). This is a test that can record brain waves to assess the risk of seizure recurrence. · Brain scans. A CT scan (computerized ...

Treatment Options for Familial Febrile Seizures

Familial febrile seizures, also known as febrile seizure plus (FS+), are a type of epilepsy that can be triggered by fever. While the exact cause is unknown, research suggests that genetic factors play a significant role in its development.

Medications for Treatment

Several medications have been studied and used to treat familial febrile seizures. These include:

• Antiepileptic drugs (AEDs): AEDs are commonly prescribed to manage epilepsy symptoms. In the case of FS+, AEDs may be given to prevent or reduce the frequency of seizures.
  • Indications for giving AEDs in FS+ include seizures lasting more than 5 minutes, febrile status epilepticus, and a family history of epilepsy [10].
• Benzodiazepines: Benzodiazepines, such as diazepam, have been shown to be effective in reducing the risk of recurrent febrile seizures [5][7]. They work by calming the nervous system.
• Other medications: Other medications, like phenytoin and valproate, may also be used to manage FS+ symptoms.

Important Considerations

It's essential to note that:

• Fever reduction is not a guarantee against febrile seizures: Giving an antipyretic at the beginning of a febrile illness has not been shown to prevent a febrile seizure [14].
• Seizures lasting ≥ 5 minutes may require medications: If seizures last longer than 5 minutes, medications may be necessary to end them. Close monitoring of circulatory and respiratory status is crucial.

References

[10] GEFS+ is a familial epilepsy syndrome in which affected individuals within a family typically have a variety of epilepsy phenotypes, varying from simple febrile seizures and febrile seizures plus with a good outcome to severe epileptic encephalopathies. ... indications for giving antiepileptic drugs are seizures lasting more than 5 min, febrile ...

[14] However, giving an antipyretic at the beginning of a febrile illness has not been shown to prevent a febrile seizure. Treatment of febrile seizures is supportive if seizures last < 5 minutes. Seizures lasting ≥ 5 minutes may require medications to end them, with careful monitoring of circulatory and respiratory status.

[7] Febrile seizures: treatment and prognosis. Epilepsia. 2000; 41:2-9. Crossref. PubMed. Google

Differential Diagnosis of Familial Febrile Seizures

Familial febrile seizures, also known as genetic epilepsy with febrile seizures plus (GEFS+), are a spectrum of seizure disorders that can be challenging to diagnose. The differential diagnosis for familial febrile seizures includes:

• Acute bacterial meningitis: This is a serious infection that requires immediate medical attention. Symptoms include fever, headache, stiff neck, and altered mental status [8].
• Viral meningitis: This is a less severe form of meningitis caused by viral infections. Symptoms are similar to those of acute bacterial meningitis but typically milder [8].
• Viral encephalitis: This is an inflammation of the brain tissue caused by viral infections. Symptoms include fever, headache, confusion, and altered mental status [8].

It's essential to consider these differential diagnoses when evaluating patients with familial febrile seizures, especially in cases where the seizure activity is severe or recurrent.

Risk Factors for Familial Febrile Seizures

Research has shown that certain genetic factors can increase the risk of developing familial febrile seizures. These include:

• Family history: A family history of febrile seizures or epilepsy increases the risk of developing familial febrile seizures [6].
• Genetic mutations: Certain genetic mutations, such as those affecting the SCN1A gene, have been associated with an increased risk of familial febrile seizures [3].

Age and Age-Related Factors

Familial febrile seizures typically occur in children under the age of three. The risk of future febrile seizure is higher after the first febrile seizure, with approximately 33-50% of patients experiencing a second febrile seizure [14].

References:

[3] by DK Smith · 2019 · Cited by 174 — Certain genes that have been identified as risk factors for familial epilepsy syndromes may also increase the risk of febrile seizures. [6] Jun 3, 2024 — Around one in four children affected by febrile seizures has a family history of the condition. Read more about the causes of febrile seizures ... [8] Aug 2, 2022 — Differentials · Acute bacterial meningitis · Viral meningitis · Viral encephalitis. [14] initial febrile seizures occur in children under the age of three. 5% of initial febrile seizures occur before the age of six months, and 5% occur after the age of six.