EEG for children with complex febrile seizures

Background

Febrile seizures (fits) can be classified as simple or complex. Complex febrile seizures are associated with a high temperature (fever), last longer than 15 minutes, occur more than once within 24 hours, and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG), which records electrical activity in the brain, on children with complex febrile seizures. The EEG may help identify why the seizures occur and predict the risk of future seizures.

Study characteristics

We searched scientific databases for randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups; these are regarded as a gold standard for trial design) that compared EEG with no EEG or a delayed EEG (occurring at second seizure) in children under five years of age with a first complex febrile seizure. We planned to look at the number of seizures that occurred at 1, 6, 12, and 24 months after EEG.

Key results and quality of the evidence

We attempted to search all possible sources but were unable to find any randomised controlled trials to address the issue up to 23 January 2017. We concluded that there is no high-quality evidence to support or refute the use of an EEG and its timing after complex febrile seizures in children. Well-designed randomised controlled trials are therefore required. We intend to update this review regularly with the hope that new randomised studies will be reported in the future.

Authors' conclusions: 

We found no RCTs as evidence to support or refute the use of EEG and its timing after complex febrile seizures among children. An RCT can be planned in such a way that participants are randomly assigned to the EEG group and to the non-EEG group with sufficient sample size. Since the last version of this review, we have found no new studies.

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Background: 

Febrile seizures can be classified as simple or complex. Complex febrile seizures are associated with fever that lasts longer than 15 minutes, occur more than once within 24 hours, and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG) for children with complex febrile seizures. A limited evidence base is available to support the use of EEG and its timing after complex febrile seizures among children.

Objectives: 

To assess the use of EEG and its timing after complex febrile seizures in children younger than five years of age.

Search strategy: 

For the latest update of this review, we searched the Cochrane Epilepsy Group Specialized Register (23 January 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (CRSO, 23 January 2017), MEDLINE (Ovid, 23 January 2017), and ClinicalTrials.gov (23 January 2017). We applied no language restrictions.

Selection criteria: 

All randomised controlled trials (RCTs) that examined the utility of an EEG and its timing after complex febrile seizures in children.

Data collection and analysis: 

The review authors selected and retrieved the articles and independently assessed which articles should be included. Any disagreements were resolved by discussion and by consultation with the Cochrane Epilepsy Group. We applied standard methodological procedures expected by Cochrane.

Main results: 

Of 41 potentially eligible studies, no RCTs met the inclusion criteria.

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