Incidence and Clinical Predictors of Recurrent Febrile Seizures Within 24 Hours in Children with Febrile Seizures at Samutprakan Hospital

Abstract

Febrile seizure (FS) is the most common neurological disorder in young children. A proportion of patients experience recurrent febrile seizures (RFS) within 24 hours; however, studies on this condition in Thailand remain limited. This study aims to determine the prevalence of recurrent febrile seizures within 24 hours and to identify factors associated with recurrence among children aged 6 months to 5 years admitted to the pediatric ward of Samutprakan Hospital between 1 January 2024 and 31 December 2024. A retrospective study design was employed.

A total of 208 patients with febrile seizures were identified, accounting for 5.14% of all pediatric admissions during the study period. The incidence of recurrent febrile seizures within 24 hours was 25 cases (12.02%). Multivariate logistic regression analysis demonstrated that two factors were significantly associated with recurrence at the 0.05 significance level: duration of fever prior to seizure ≤12 hours (OR = 1.45, 95% CI [1.03, 1.86]) and white blood cell count < 15,000/μL (OR = 1.25, 95% CI [1.01, 1.55]). Other factors-including age, sex, body temperature at seizure onset, seizure characteristics, number of prior febrile seizures, family history of febrile seizure or epilepsy, administration of acetaminophen and/or ibuprofen in the emergency department, tepid sponging in the emergency department, underlying causes of fever, presence of anemia, and serum sodium level-showed no statistically significant differences between recurrence and non-recurrence groups. Most recurrent seizures occurred within the first 6 hours and did not exceed 24 hours after admission.

These findings may inform clinical management strategies for children with febrile seizures, helping guide risk stratification and prioritization of care.