Febrile Convulsions in Children: Correct Statement Analysis
The correct answer is B: Complex febrile seizures are more likely to progress to epilepsy. This is the only accurate statement among the options provided, with complex febrile seizures dramatically increasing epilepsy risk compared to simple febrile seizures.
Analysis of Each Statement
Statement A: "There is a 2% chance to develop epilepsy" - INCORRECT
- Children with simple febrile seizures have approximately 1% risk of developing epilepsy by age 7 years, which is essentially the same as the general population 1, 2, 3
- The 2.4% risk figure applies only to a specific subset of children with multiple risk factors: those with multiple simple febrile seizures, age younger than 12 months at first seizure, AND family history of epilepsy—and this is the risk by age 25 years, not the baseline risk 1, 3
- This statement oversimplifies and misrepresents the actual risk profile 1
Statement B: "Complex febrile seizures are more likely to progress to epilepsy" - CORRECT
- Complex febrile seizures dramatically increase epilepsy risk, with the risk rising to nearly 50% by age 25 years when three or more complex features are present 3
- This represents a substantial elevation compared to the 1% baseline risk for simple febrile seizures 1, 3
- Complex febrile seizure features include: duration ≥15 minutes, focal neurologic findings, or recurrence within 24 hours 1, 2
- The American Academy of Pediatrics emphasizes that complex febrile seizures require closer follow-up due to this substantially higher epilepsy risk 3
Statement C: "If parents had febrile seizures, it will increase the chance to progress to epilepsy" - INCORRECT AS STATED
- A family history of epilepsy (not febrile seizures) is one of the risk factors that increases epilepsy risk to 2.4% by age 25 years when combined with other factors 1, 3
- The statement confuses parental history of febrile seizures with family history of epilepsy 1
- Family history of febrile seizures does increase recurrence risk of febrile seizures but does not independently increase epilepsy risk in the way this statement implies 1
Statement D: "Using antipyretics will decrease the chance of febrile convulsions" - INCORRECT
- Antipyretics do not prevent febrile seizures or reduce recurrence risk, according to the American Academy of Pediatrics 1, 2, 3
- Multiple high-quality randomized controlled trials demonstrate that antipyretic agents (acetaminophen, ibuprofen, diclofenac) are ineffective for preventing recurrences of febrile seizures 4, 5, 6
- A 2009 randomized controlled trial of 231 children found no significant difference in febrile seizure recurrence between those receiving antipyretic agents (23.4%) versus placebo (23.5%) 5
- The American Academy of Pediatrics recommends that antipyretics should be used for the child's comfort and to prevent dehydration, but not for seizure prevention 1, 2, 3
- Fever was significantly higher during episodes with seizure regardless of medication given, demonstrating that antipyretics cannot prevent the seizures themselves 5
Clinical Implications
- Simple febrile seizures have an excellent prognosis with 1% epilepsy risk and no long-term adverse effects on IQ, academic performance, or neurocognitive function 1, 2, 3
- Complex febrile seizures require neurological consultation and closer follow-up due to substantially elevated epilepsy risk 1, 3
- Neither continuous nor intermittent anticonvulsant prophylaxis is recommended for simple febrile seizures, as potential toxicities clearly outweigh minimal risks 1, 2
- Parent education should emphasize the benign nature of simple febrile seizures while clarifying that fever control does not prevent seizures 3, 7