Is temperature regulation different in children susceptible to febrile seizures?

Objective: To examine the relationship between the presence and magnitude of fever and susceptibility to febrile seizures, defined as a known family history of febrile seizures. Methods: Reanalysis of a case-control study dataset (Am J Dis Child. 1993;147:35-39). The magnitude of presenting fever was examined between the incident febrile seizure group (N=75) and febrile control group (N=150) for a family history of febrile seizures. The presence of fever was examined between the febrile control group (N=150) and the afebrile control group (N=150) for a family history of febrile seizures. Results: Children with incident febrile seizures had a higher temperature in the emergency department than febrile controls (39.3°C vs 39.0°C, p=.004). Febrile control children with a known family history of febrile seizures had higher temperatures than those without a known family history (39.5°C vs 38.9°C, p=.04). A model of fever magnitude within the febrile group (seizures and controls) suggested that most of this relationship was on the basis of family history of febrile seizures rather than seizure or control status, with a possibility of interaction. Within the control children (febrile and afebrile), a known family history of febrile seizures was associated with fever (OR 3.4, 95% CI: 1.1,10.7). Conclusions: Children susceptible to febrile seizures through a known family history of febrile seizures appear more likely to present to emergency departments with fever, and when compared to their febrile counterparts, a fever of higher magnitude. This data supports Rantala's assertion "It may be that regulation of temperature is different in children susceptible to febrile seizures".