Original article| Volume 35, ISSUE 6, P395-399, December 2006

Influenza A and Febrile Seizures in Childhood

      The aims of the present study are to identify predisposing factors of febrile seizures in influenza A infection and to clarify the special characteristics of febrile seizures in children with influenza A infection. Between January and July 2005, children hospitalized because of febrile seizures and subsequently confirmed influenza A infection were enrolled as subjects. Age-matched control subjects were those admitted as a result of influenza A infection but no febrile seizures (control 1) and children who developed febrile seizures with negative viral studies (control 2). Significant factors for the development of febrile seizures include: history of febrile seizures, family history of seizure disorders, and coexisting gastroenteritis. Independent risk factor for febrile seizures was history of febrile seizures (odds ratio 7.58, 95% confidence interval CI 1.48 to 38.84, P = 0.015). When compared with children who developed febrile seizures with negative virus studies, children who developed febrile seizures in influenza A infection had a significantly higher maximum body temperature, shorter duration of fever before seizure onset, and more frequent occurrence of partial seizures. Current episode represented first seizure in 26.5% of children infected with influenza A as compared with 50% of children whose virus studies were negative (P = 0.04). The findings suggest that effective vaccination may prevent development of febrile seizures, especially in those patients with past history of febrile seizures. Rapid diagnostic testing for influenza infection in the management of complex febrile seizures, especially during influenza season, is cost-effective.
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        • Annegers J.F.
        • Hauser W.A.
        • Elveback L.R.
        • Kurtland L.T.
        Factors prognostic of unprovoked seizures after febrile convulsion.
        N Engl J Med. 1987; 316: 493-498
        • Berg A.T.
        • Shinnar S.
        Unprovoked seizures in children with febrile seizures: Short-term outcome.
        Neurology. 1996; 47: 562-568
        • Nelson K.B.
        • Ellenberg J.H.
        Predictors of epilepsy in children who have experienced febrile seizures.
        N Engl J Med. 1976; 295: 1029-1033
        • Shinnar S.
        Prolonged febrile seizures and mesial temporal sclerosis.
        Ann Neurol. 1998; 43: 411-412
        • Lewis H.M.
        • Parry J.V.
        • Parry R.P.
        • Davis H.A.
        • Sanderson P.J.
        • Tyrrell D.A.
        Role of viruses in febrile convulsion.
        Arch Dis Child. 1979; 54: 309-313
        • Van Zeijl J.H.
        • Mulaart R.A.
        • Galama J.M.D.
        The pathogenesis of febrile seizures: Is there a role for specific infections?.
        Rev Med Virol. 2002; 12: 93-106
        • Suga S.
        • Suzuki K.
        • Ihira M.
        • et al.
        Clinical characteristics of febrile convulsions during primary HHV-6 infection.
        Arch Dis Child. 2000; 82: 62-66
        • Morishima T.
        • Togashi T.
        • Yokota S.
        • collaborative study group on influenza-associated encephalopathy in Japan
        Encephalitis and encephalopathy associated with influenza epidemic in Japan.
        Clin Infect Dis. 2002; 35: 512-517
        • Chiu S.S.
        • Tse C.C.
        • Lau Y.L.
        • Peiris M.
        Influenza A infection is an important cause of febrile seizures.
        Pediatrics. 2001; 108 (Available at:
        • Chan K.H.
        • Pope M.W.
        • Yup A.
        • et al.
        Evaluation of the Directigen Flu A+B test for rapid diagnosis of Influenza Virus Type A and B infections.
        J Clin Microbiol. 2002; 40: 1675-1680
        • Commission on Epidemiology and Prognosis, International League Against Epilepsy
        Guidelines for epidemiologic studies on epilepsy.
        Epilepsia. 1993; 34: 592
        • Annegers J.F.
        • Blakely S.A.
        • Hauser W.A.
        • Kurtland L.T.
        Recurrence of febrile convulsion in a population-based cohort.
        Epilepsy Res. 1990; 66: 209-216
        • Berg A.T.
        • Shinnar S.
        • Darefsky A.S.
        • et al.
        Predictors of recurrent febrile seizures.
        Arch Ped Adolesc Med. 1997; 151: 371-378
        • Kawada J.I.
        • Kimura H.
        • Ito Y.
        • Hara S.
        • Iriyama M.
        • Morishima T.
        Systemic cytokine responses in patients with influenza associated encephalopathy.
        J Infect Dis. 2003; 188: 690-698
        • Brocklebank J.R.
        • Court S.D.M.
        • McQuillin J.
        • Gardner R.S.
        Influenza A infection in children.
        Lancet. 1972; 2: 497-500
        • Price D.A.
        • Postlehwaite R.J.
        • Longson M.
        Influenzavirus A2 infections presenting with febrile convulsions and gastrointestinal symptoms in young children.
        Clin Pediatr. 1976; 15: 361
        • Hall C.B.
        • Long C.E.
        • Schnabel K.C.
        • et al.
        Human herpesvirus-6 infection in children: A prospective study of complications and reactivation.
        N Engl J Med. 1994; 331: 432-438
        • Maricich S.M.
        • Neul J.L.
        • Lotze T.E.
        • et al.
        Neurologic complications associated with influenza A in children during the 2003-2004 influenza season in Houston, Texas.
        Pediatrics. 2004; 114: e626-e633
        • Masuyama T.
        • Matsuo M.
        • Ichimaru T.
        • Ishii K.
        • Tsuchiya K.
        • Hamasaki Y.
        Possible contribution of interferon-α in influenza.
        Pediatr Neurol. 2002; 27: 289-292
        • Steininger C.
        • Popow-Kraupp T.
        • Laferl H.
        • et al.
        Acute encephalopathy associated with influenza A virus infection.
        Clin Infect Dis. 2003; 36: 567-574
        • Schlesinger R.W.
        • Husak P.J.
        • Bradshaw G.L.
        • Panayotov P.P.
        Mechanisms involved in natural and experimental neuropathogenicity of influenza viruses: Evidence and speculation.
        Adv Virus Res. 1998; 50: 289-379
        • Van Zeijl J.H.
        • Mullaart R.A.
        • Borm G.F.
        • Galama J.M.D.
        Recurrence of febrile seizures in the respiratory season is associated with influenza A.
        J Pediatr. 2004; 145: 800-805
        • Berg A.T.
        • Shinnar S.
        • Shapiro E.D.
        • Salomon M.E.
        • Crain E.F.
        • Hauser W.A.
        Risk factors for a first febrile seizure: A matched case-control study.
        Epilepsia. 1995; 36: 334-341
        • Stricker T.
        • Sennhauser F.H.
        Letter to editors.
        Ped Infect Dis J. 2004; 23: 480
        • Nelson K.B.
        • Ellenberg J.H.
        Prognosis in children with febrile seizures.
        Pediatrics. 1978; 61: 720-727
        • Verity C.M.
        • Golding J.
        Risk of epilepsy after febrile convulsions; a national cohort study.
        Br Med J. 1991; 303: 1373-1376