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Background <p>Febrile seizures are classically defined as occurring between six months and five years of age;&#xa0;however, fever-associated seizures may also occur in older children, a group that remains relatively underrecognized. This age group may present with different clinical characteristics and a potentially increased risk of&#xa0;epilepsy or underlying structural abnormalities.</p> Methods <p>We retrospectively analyzed children older than five years who presented with fever-associated seizures&#xa0;to the pediatric emergency department between July 2019 and July 2024. Demographic characteristics, seizure&#xa0;semiology, family history, electroencephalography(EEG) and neuroimaging results, and long-term epilepsy&#xa0;outcomes were evaluated. Patients with prior epilepsy, neurodevelopmental disorders, or metabolic diseases were&#xa0;excluded.</p> Results <p>One hundred ten children (mean age:7.3 years; 73.6% male) were included. Most patients (80%)&#xa0;experienced simple febrile seizures; however, complex seizures occurred in 20%. EEG abnormalities were present&#xa0;in 33.3% of those tested (45/110), and neuroimaging revealed structural abnormalities in 2/51 patients. Over a&#xa0;median follow-up of 18 months, 14 children (12.7%) developed epilepsy, a markedly higher risk being observed&#xa0;in those with complex seizures (40.9% vs. 5.7%) and in children over seven.</p> Conclusion <p>Febrile seizures occurring beyond the age of five may represent a clinically relevant subgroup.&#xa0;Although many children present with simple features and follow a favorable course, complex seizure&#xa0;characteristics and older age may be associated with an increased risk of subsequent epilepsy. Selected patients&#xa0;may therefore require careful clinical evaluation and follow-up.</p>

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Fever seizures beyond the typical age: clinical characteristics and subsequent epilepsy risks in children over five

  • 期刊论文

  • 发表日期：

    2026年6月18日

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  • Selcan Ozturk,
  • Hatice Hilal Kirkgoz,
  • Sakine Sanlikan,
  • Neziha Oz,
  • Dogukan Susam,
  • Murat Dogan

摘要

Background

Febrile seizures are classically defined as occurring between six months and five years of age; however, fever-associated seizures may also occur in older children, a group that remains relatively underrecognized. This age group may present with different clinical characteristics and a potentially increased risk of epilepsy or underlying structural abnormalities.

Methods

We retrospectively analyzed children older than five years who presented with fever-associated seizures to the pediatric emergency department between July 2019 and July 2024. Demographic characteristics, seizure semiology, family history, electroencephalography(EEG) and neuroimaging results, and long-term epilepsy outcomes were evaluated. Patients with prior epilepsy, neurodevelopmental disorders, or metabolic diseases were excluded.

Results

One hundred ten children (mean age:7.3 years; 73.6% male) were included. Most patients (80%) experienced simple febrile seizures; however, complex seizures occurred in 20%. EEG abnormalities were present in 33.3% of those tested (45/110), and neuroimaging revealed structural abnormalities in 2/51 patients. Over a median follow-up of 18 months, 14 children (12.7%) developed epilepsy, a markedly higher risk being observed in those with complex seizures (40.9% vs. 5.7%) and in children over seven.

Conclusion

Febrile seizures occurring beyond the age of five may represent a clinically relevant subgroup. Although many children present with simple features and follow a favorable course, complex seizure characteristics and older age may be associated with an increased risk of subsequent epilepsy. Selected patients may therefore require careful clinical evaluation and follow-up.