Predictive value of EEG for febrile seizure recurrence

Objective: To define the role of the EEG in predicting recurrence of febrile seizures (FS) in children after a first FS. Methods: Children with a first simple or complex FS who underwent EEG at our hospital were retrospectively enrolled. EEG recordings were classified in three groups: normal, abnormal (slow activity or epileptiform discharges), and pseudo-petit mal dis- charge (PPMD) pattern. Children were followed-up for at least three years. Results: A total of 126 patients met the entry criteria, and 113 of them completed the follow-up. Risk of FS recurrence decreased linearly with increasing age (2% per month). The risk was higher among patients with PPMD pattern (absolute risk 86%, adjusted relative risk 2.00) and abnormal EEG (epileptiform discharges: absolute risk 71%, adjusted relative risk 2.00; slow activity: absolute risk 56%, adjusted relative risk 1.44), compared with those with normal EEG (absolute risk 41%). Conclusions: PPMD and abnormal EEG should be considered as an independent risk factor for FS recurrence.