Clinical characteristics of 910 first febrile seizures in children aged 8 to 34 months, evaluated by telephone interview of parents, are reported from the University of Washington School of Medicine, Seattle, WA. A male preponderance of 57% and a family history of febrile seizures in 29% were elicited. Focal seizures, including only eye deviation in the definition of some, were reported in 18%; Todd’s paresis in 4%. Infections associated with fever included otitis media 32%, tonsillitis or URI 12%, viral exanthem 12%, and immunizations 2%. The average temperature recorded at the time of the seizure was 103.7°F. Prolonged seizures and recurrence in the same illness, factors related to increased risk of subsequent nonfebrile seizures, were significantly more frequent in children aged 8-11 months, when compared to those older than 12 months. [1]

COMMENT. Notwithstanding the limitations of the method of data collection, some of the Seattle findings are of interest as they compare with numerous previous reports of similar clinical febrile seizure studies. Between 1924 and 1965, 51 articles involving approximately 10,000 febrile seizure patients were published in the world literature [2]. A male preponderance was established in 29 series, with a mean sex ratio of 1.4 to 1, a family history of febrile seizures was found in 30%, and the mean threshold convulsive temperature was 104.0°F. In contrast to the Seattle findings, otitis media accounted for only 2.9% of associated fevers, and tonsillitis or pharyngitis was by far the most frequent illness, occurring in 59% of febrile episodes. Focal seizures were reported in a mean of 11%, and 14% in one prospective study. The incidence of Todd’s paresis was 3.7% and similar to that observed in Seattle. Of prognostic importance is the confirmation of age at onset (< 1 year) as a risk factor for complex febrile seizures in this study.