ABSTRACT

To investigate whether pseudo-petit mal discharge is a useful marker of epilepsy on electroencephalogram in patients with recurrent febrile seizures.

The retrospective study included 255 out of 1255 children aged 6-66 months that were followed up in our hospital due to febrile seizures over the period 2010-2020. All the patients underwent an electroencephalogram examination and electroencephalogram abnormalities were classified into 3 groups: group I (normal), no epileptiform or background abnormalities; group II (abnormal), focal or generalized discharge or electroencephalogram slowing; group III (pseudo-petit mal discharge). Patients with pseudo-petit mal discharge were followed up for epilepsy development for a period of 7 years after the age of 72 months.

The prevalence of pseudo-petit mal discharge on electroencephalogram was significantly higher in patients with complex febrile seizures compared to recurrent febrile seizures (P = .005). Ten (6.1%) recurrent febrile seizure patients with normal electroencephalogram findings were followed up for epilepsy. Pseudo-petit mal discharge was found to persist in 7 (12%) out of 58 recurrent febrile seizure patients with pseudo-petit mal discharge for a period of 7 years, after which no seizure activity was detected on electroencephalogram and thus no follow-up was performed for epilepsy. Pseudo-petit mal discharge that patients with recurrent febrile seizure seizures had 2.3 (1.107-1.988) risk of having >4 seizure times and 1.9 (1.335-2.569) times more risk of being male. Compared to complex febrile seizures, those with more recurrent febrile seizure seizures had longer pseudo-petit mal discharge periods and greater frequency.

The presence of pseudo-petit mal discharge on electroencephalogram could be an indication of especially recurrent febrile seizure in children with febrile seizures and pseudo-petit mal discharge could be a marker of favorable prognosis in long-term follow-up of febrile seizures patients in terms of epilepsy development since epilepsy was diagnosed in patients without pseudo-petit mal discharge and was not detected in patients with pseudo-petit mal discharge. Although pseudo-petit mal discharge is an important predisposing factor for the recurrence of febrile seizures, it has been shown that it is not a risk factor for epilepsy development.

Keywords: Electroencephalogram, febrile seizures, prognosis, pseudo-petit mal discharge