1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-2014-28-5-4 10.15844/pedneurbriefs-28-5-4 Febrile Seizures Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Environmental Factors Associated with Febrile Seizures http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * http://orcid.org/0000-0002-0798-0131 Millichap John J. MD 1 2 Division of Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 05 2014 31 10 2015 28 5 35 36 Copyright: © 2014 The Author(s) 2014 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Increased association between febrile convulsion and allergic rhinitis in children: a nationwide population-based retrospective cohort study

Investigators from Taichung, Taiwan, conducted a nationwide population-based retrospective study of the association between febrile seizure (FS) and allergic rhinitis.

 Febrile Seizure Allergic Rhinitis Allergic Epilepsy

Investigators from Taichung, Taiwan, conducted a nationwide population-based retrospective study of the association between febrile seizure (FS) and allergic rhinitis. During an average 6.7 years follow-up of 1304 children with FSs, the incidence of allergic rhinitis in the FS group was higher, and after 11 years, the allergic rhinitis incidence was 4% higher than controls (p < 0.0001). Risk of allergic rhinitis in the FS group is 1.21 times higher than in the control group, and the risk is even higher (18.9) in patients with more than 3 FS-related medical visits. Both disorders have similar cytokine profiles and viral infection association. [2]

COMMENTARY. Fever and height of the body temperature as a measure of the FS threshold have an essential role in the mechanism of the FS. The cause of fever is almost always viral, most frequently HHV-6 in the United States and influenza in Japan. Some viruses have neurotropic properties, leading to the theory of a transient encephalitic or encephalopathic process in some cases. Additional factors involved in the mechanism of the FS include a genetic susceptibility, age and maturation, and cytokine and immune response to infection [1]. The association of allergic rhinitis and FS in the present study was significantly higher in children 0.5 to 2 yrs of age (the age of susceptibility to FS), of male sex, and with frequent FS-related clinic visits. Children with FS had a higher association with other atopic comorbidities, including asthma (8.08% vs 5.62%, p = 0.006) [2].

Allergies and immune reactions are proposed as factors in the etiology of FS [3]. In 1953, Dees, reporting on EEG observations in so-called “allergic epilepsy,” emphasized the significance of occipital dysrhythmia in children with allergies complicated by convulsions [4]. Allergic disorders may also increase the risk of ADHD [5], and the risk of ADHD is increased in children with FS [6]. A significant association between proinflammatory cytokine, IL-1B, and both ADHD and FS may be a link in the mechanism of these disorders [6].

Millichap JG Millichap JJ Role of viral infections in the etiology of febrile seizures Pediatr Neurol 2006 Sep 35 3 165 72 10.1016/j.pediatrneurol.2006.06.004 16939854 Lin WY Muo CH Ku YC Sung FC Kao CH Increased association between febrile convulsion and allergic rhinitis in children: a nationwide population-based retrospective cohort study Pediatr Neurol 2014 Apr 50 4 329 33 10.1016/j.pediatrneurol.2013.12.011 24630280 Millichap JG Febrile Convulsions 1968 New York Macmillan 84 5 Dees S Electro-encephalography in allergic epilepsy South Med J 1953 Jun 46 6 618 20 13076775 Shyu CS Lin HK Lin CH Fu LS Prevalence of attention-deficit/hyperactivity disorder in patients with pediatric allergic disorders: a nationwide, population-based study J Microbiol Immunol Infect 2012 Jun 45 3 237 42 10.1016/j.jmii.2011.11.008 22580087 Ku YC Muo CH Ku CS Chen CH Lee WY Shen EY Risk of subsequent attention deficit-hyperactivity disorder in children with febrile seizures Arch Dis Child 2014 Apr 99 4 322 6 10.1136/archdischild-2013-304647 24307684