Risk factors for secondary epilepsy in children with complex febrile seizures and their effect on growth and development—a retrospective cohort study

Abstract

Background: Complex febrile seizures are prolonged and can cause neurologic abnormalities, leading to secondary epilepsy and affecting growth and development. At present, the mechanism of secondary epilepsy in children with complex febrile seizures is not clear, and this study aimed to explore the risk factors for secondary epilepsy in children with complex febrile seizures and analyze its effects on the growth and development of children. Methods: The data of 168 children with complex febrile seizures admitted to the Ganzhou Women and Children’s Health Care Hospital between January 2018 and December 2019 were collected retrospectively and divided into a secondary epilepsy group (n=58) and control group (n=110) according to whether the children had secondary epilepsy or not. The differences in clinical features between the 2 groups were compared, and logistic regression analysis was used to explore the risk factors for secondary epilepsy in children with complex febrile seizures. A nomogram prediction model for secondary epilepsy in children with complex febrile seizures was established and verified using the R 4.0.3 statistical software, and the effect of secondary epilepsy on the growth and development of children was analyzed. Results: Multivariate logistic regression analysis showed that family history of epilepsy, generalized seizures, number of seizures, and duration of seizures were independent influencing factors of secondary epilepsy in children with complex febrile seizures (P<0.05). The dataset was randomly divided into a training set and a validation set, with a sample size of 84 in the training set and 84 in the validation set. The area under the receiver operating characteristic (ROC) curve of the training set was 0.845 (95% confidence interval: 0.756–0.934), and the area under the ROC curve of the validation set was 0.813 (95% confidence interval: 0.711–0.914). Compared with the control group, the Gesell Development Scale score in the secondary epilepsy group was significantly reduced (77.84±8.86 vs. 85.64±8.65, P<0.001). Conclusions: The nomogram prediction model could better identify complex febrile seizures children at high risk of secondary epilepsy. Strengthening intervention in such children may be beneficial for improving their growth and development.