Investigators at New York Presbyterian Hospital determined the effect of a first febrile seizure (FS) on development, using measures of cognition, motor ability, and adaptive behavior. Children (n=159) from a low socioeconomic environment, evaluated within one month of the ED visit for a first FS and one year later, showed no difference in performance compared to that in 142 controls. Within-group differences in cognition occurred in cases and controls, the decline in cases reaching significance. Factors independent of the FS that were associated with group changes in function and delay in developmental milestones over time included poor socioeconomic status, TV watching, fewer books, and lack of breastfeeding. The mean decline over time in cognition was greater in children with complex FS compared to children with simple FS, and children with complex FS were more likely to come from low-income households. Simple FS occurred in 65.8% (N=104), and complex FS in 34.2% (N=54). 
COMMENT. The authors conclude that a first FS does not pose an increased risk of poor developmental outcome over time, but a decline in cognition and behavior following a FS may be associated with an impaired socioeconomic environment or a FS that is complex in type.