热性惊厥患儿血清细胞因子水平的变化及临床意义

目的 了解6月～2岁单纯性和复杂性热性惊厥患儿血清IFN-α,IL-8和TNF-α水平的异常变化。方法 应用ELISA法检测64例单纯性热性惊厥和52例复杂性热性惊厥患儿血清IFN-α,IL-8和TNF-α的含量,并对IL-8和TNF-α进行了相关性研究。结果 单纯性热性惊厥组血清TFN-α,IL-8和TNF-α的含量分别为467.68±112.46 ng/L,74.38±18.74 ng/L和812.36±232.38 ng/L,其含量明显高于正常对照组（P﹤0.01）,也明显高于单纯性热性惊厥组（P﹤0.01）。IL-8和TNF-α在这两组疾病中分别呈正相关（r1=0.565,r2=0.64,P ﹤0.01）。结论 ①在单纯性热性惊厥和复杂性热性惊厥中,细胞因子明显增加,在增强机体免疫系统抗感染的同时,也激发了免疫性炎症反应,对组织细胞可能产生损伤。②IL-8和TNF-α在两组疾病中形成一对辅助因子,并参与了整个病理过程。     

惊厥患儿外周血单个核细胞核因子-κB表达和血清可溶性白细胞介素2受体及抗心磷脂抗体的变化

目的 探讨惊厥患儿外周血单个核细胞核因子(NF)-κB和血清可溶性白细胞介素2受体(SIL-2R)水平、抗心磷脂抗体(ACA)阳性率的变化及临床意义.方法 选择30例高热惊厥患儿、64例癫疴患儿及38例健康儿童,采用流式细胞术检测外周血单个核细胞NF-κB表达,采用ELISA法测定血清中SIL-2R水平及ACA阳性率.结果 癫(癎)全身发作组、部分发作组、高热惊厥组患儿外周血单个核细胞NF-κB的表达率分别为22.23%±5.31%、3.58%±1.54%、2.18%±0.91%,较健康对照组(0.44%±0.25%)明显升高,差异有非常显著性(P<0.01).癫(癎)全身发作组、部分发作组、高热惊厥组血清SIL-2R水平分别为(103.08 ±37.78)ng/ml、(64.56±14.36)ng/ml、(38.36±7.93)ng/ml,均高于健康对照组(22.22 ±7.30)ng/ml,差异有非常显著性(P<0.01);各癫(癎)组高于高热惊厥组(P<0.01);全身发作组高于部分发作组(p<0.01).癫(癎)全身发作组、部分发作组、高热惊厥组血清ACA阳性率分别为33.3%、28.6%和26.7%,均高于健康对照组5.3%,差异有显著性(P<0.01,P<0.05).结论 癫(癎)和高热惊厥患儿外周血单个核细胞NF-κB表达和血清SIL-2R、ACA水平异常,可能参与其发病过程.     

惊厥患儿外周血单个核细胞核因子-κB表达和血清可溶性白细胞介素2受体及抗心磷脂抗体的变化

目的 探讨惊厥患儿外周血单个核细胞核因子(NF)-κB和血清可溶性白细胞介素2受体(SIL-2R)水平、抗心磷脂抗体(ACA)阳性率的变化及临床意义.方法 选择30例高热惊厥患儿、64例癫疴患儿及38例健康儿童,采用流式细胞术检测外周血单个核细胞NF-κB表达,采用ELISA法测定血清中SIL-2R水平及ACA阳性率.结果 癫(癎)全身发作组、部分发作组、高热惊厥组患儿外周血单个核细胞NF-κB的表达率分别为22.23%±5.31%、3.58%±1.54%、2.18%±0.91%,较健康对照组(0.44%±0.25%)明显升高,差异有非常显著性(P<0.01).癫(癎)全身发作组、部分发作组、高热惊厥组血清SIL-2R水平分别为(103.08 ±37.78)ng/ml、(64.56±14.36)ng/ml、(38.36±7.93)ng/ml,均高于健康对照组(22.22 ±7.30)ng/ml,差异有非常显著性(P<0.01);各癫(癎)组高于高热惊厥组(P<0.01);全身发作组高于部分发作组(p<0.01).癫(癎)全身发作组、部分发作组、高热惊厥组血清ACA阳性率分别为33.3%、28.6%和26.7%,均高于健康对照组5.3%,差异有显著性(P<0.01,P<0.05).结论 癫(癎)和高热惊厥患儿外周血单个核细胞NF-κB表达和血清SIL-2R、ACA水平异常,可能参与其发病过程.     

惊厥患儿外周血单个核细胞核因子-κB表达和血清可溶性白细胞介素2受体及抗心磷脂抗体的变化

目的 探讨惊厥患儿外周血单个核细胞核因子(NF)-κB和血清可溶性白细胞介素2受体(SIL-2R)水平、抗心磷脂抗体(ACA)阳性率的变化及临床意义.方法 选择30例高热惊厥患儿、64例癫疴患儿及38例健康儿童,采用流式细胞术检测外周血单个核细胞NF-κB表达,采用ELISA法测定血清中SIL-2R水平及ACA阳性率.结果 癫(癎)全身发作组、部分发作组、高热惊厥组患儿外周血单个核细胞NF-κB的表达率分别为22.23%±5.31%、3.58%±1.54%、2.18%±0.91%,较健康对照组(0.44%±0.25%)明显升高,差异有非常显著性(P<0.01).癫(癎)全身发作组、部分发作组、高热惊厥组血清SIL-2R水平分别为(103.08 ±37.78)ng/ml、(64.56±14.36)ng/ml、(38.36±7.93)ng/ml,均高于健康对照组(22.22 ±7.30)ng/ml,差异有非常显著性(P<0.01);各癫(癎)组高于高热惊厥组(P<0.01);全身发作组高于部分发作组(p<0.01).癫(癎)全身发作组、部分发作组、高热惊厥组血清ACA阳性率分别为33.3%、28.6%和26.7%,均高于健康对照组5.3%,差异有显著性(P<0.01,P<0.05).结论 癫(癎)和高热惊厥患儿外周血单个核细胞NF-κB表达和血清SIL-2R、ACA水平异常,可能参与其发病过程.     

癫癎和热性惊厥患儿脑脊液生长抑素的变化

目的探讨癫癎(EP)和热性惊厥(FC)患儿脑脊液(CSF)生长抑素(SS)含量及其与EP和FC发病机制关系.方法采用放射免疫法(RIA)测定EP和FC患儿CSF中SS含量.结果 EP组CSF中SS水平(139.59±45.95)ng/L明显高于FC组(89.71±37.51)ng/L和对照组(77.31±37.10)ng/L(P均＜0.05);FC组CSF中SS水平(89.71±37.51)ng/L与对照组比较无显著性差异(P＞0.05);严重组EP和FC患儿CSF中SS水平与普通组比较均无显著性差异(P均＞0.05).结论SS参与EP发作,可能有致EP发作作用,而与FC的惊厥发作无关.     

哮喘患儿血清IL 12 TGFβ1 与IgE 水平变化的研究

目的：检测哮喘患儿不同病期的白细胞介素12 ( IL-12) 、转化生长因子β1 ( TGFβ1 ) 与免疫球蛋白E( IgE) 水平变化的规律,并探讨不同病期IL-12,TGFβ1水平与IgE水平的相关性,据此阐述它们在哮喘中的临床意义。方法：采用ELISA 方法检测85例哮喘患儿及30例正常儿童的血清IL-12,TGFβ1与总IgE 水平。结果：哮喘组血清IL-12,TGFβ1水平明显低于对照组,而IgE 水平则哮喘组明显高于对照组,且发作期IL-12,TGFβ1 水平（28.42±10.73 ng/L,40.25±11.73 pg/mL）明显低于缓解期（40.42±15.26 ng/L,65.41±22.38 pg/mL）,差异有显著性 (P< 0. 01),缓解期血清IL-12,TGFβ1 水平明显低于对照组（67.42±20.58 ng/L,178.54±90.56 pg/mL）,差异有显著性(P<0.01),发作期血清IgE 水平（280.35±80.54 IU/mL）明显高于缓解期（145.67±51.25 IU/mL）, 差异有显著性(P< 0.01), 缓解期血清IgE 水平明显高于对照组（53.61±13.32 IU/mL）, 差异有显著性(P<0.01),哮喘患儿血清IL-12,TGFβ1水平与IgE呈负相关(P< 0.01)。结论：哮喘患儿存在IL-12,TGFβ1及IgE 水平失衡,提示IL-12,TGFβ1 在哮喘的发病中起着重要作用,检测它们的水平可为哮喘的诊断及判断病情提供依据。     

氢质子磁共振波谱在原发性癫癎中的应用研究

目的：应用氢质子磁共振波谱(proton magnetic resonance spectroscopy, 'H-MRS)检测癫癎患儿的脑组织生化代谢物,探讨'H-MRS在原发性癫癎中的临床应用价值及意义。方法：对33例原发性癫癎患儿（癫癎组,其中14例有热性惊厥史）和6例正常儿童（对照组）进行常规头颅MRI和颞叶海马区的'H-MRS检查。检测N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)和乳酸(Lac)的信号强度,计算并比较NAA/（Cho+Cr）和Lac/Cr的比值。结果：头颅MRI检查：除1例癫癎患儿表现为髓鞘发育不良外其余所有研究对象均无异常。'H-MRS检测：NAA/（Cho+Cr）比值在癫癎组为0.64±0.07,低于对照组(0.73±0.05)（P＜0.01）;同时伴有热性惊厥史的癫癎患儿为0.61±0.07,低于不伴有热性惊厥史的癫癎患儿（0.66±0.06）（P＜0.05）。癫癎组Lac/Cr比值与对照组差异无统计学意义。结论：'H-MRS作为一项无创的检查,能更敏感地发现癫癎患儿的早期脑损伤,为癫癎的诊断和评估预后提供客观依据。［中国当代儿科杂志,2010,12（6）：425-428］     

慢性胃炎患儿血中胃泌素胃动素生长抑素变化的研究

目的：胃肠激素是维持胃肠动力功能的重要调节因素,胃肠动力病学研究在国外已开展数十年,而国内小儿胃肠动力病仅在最近几年受到关注,有关基础与临床研究有相当重要的意义。该研究旨在探讨小儿慢性胃炎血中胃泌素(GAS)、胃动素(MTL)、生长抑素(SS)分泌变化与疾病的关系。 方法：采用放射免疫法对50例观察组慢性胃炎患儿(含Hp阳性组21例、Hp阴性组29例)及30例对照组患儿的空腹血GAS,MTL,SS进行测定。并对50例观察组患儿行胃镜检查,取胃窦粘膜2块及十二指肠球部粘膜1块作快速尿素酶试验(RUT)和病理组织学Giemas染色。 结果：①慢性胃炎组患儿血清GAS含量均值为 141.5±28.0 ng/L,高于对照组均值68.7±17.9 ng/L,差异有显著性(t=4.317,P<0.01)。同时Hp阳性组GAS含量均值为173.0±46.0 ng/L,亦明显高于Hp阴性组均值110.0±20.0 ng/L,差异有显著性(t=3.274,P<0.01)。②慢性胃炎组患儿血浆MTL含量均值为 199.5±61.0 ng/L,低于对照组均值 281.0±76.0 ng/L,差异有显著性(t=4.416,P<0.01)。Hp阳性组血浆MTL含量与阴性组之间差异无显著性。③慢性胃炎组患儿血清SS含量均值为 166.4±18.0 ng/L,低于对照组均值 229.0±45.0 ng/L,差异有显著性(t=2.131,P<0.05)。Hp阳性组血清SS含量均值为144.5±11.0 ng/L,明显低于Hp阴性组均值187.4±26.0 ng/L,差异有显著性(t=3.897,P<0.01)。 结论：慢性胃炎患儿存在胃肠激素的异常分泌, 其分泌水平的异常在慢性胃炎的发病机制中起重要作用,并为慢性胃炎患儿是否存在Hp感染,提供了诊断和治疗的理论依据。［中国当代儿科杂志,2004, 6(4): 287-290］     

单纯性肾病患儿甲状腺功能测定的临床意义

目的：　探讨单纯性肾病血清甲状腺素水平的变化。方法：　用双抗体放免法检测肾病患儿组与健康对照组各 20例血清甲状腺素,比较两组变化的差异。结果：　对照组血清甲状腺素水平正常,肾病组血清T3 ,T4 ,TSH有不同程度的变化 ,分别为 (1.0± 0 .5)nmol/L ,(15.5±32.4)nmol/L,(20.2±13.2)mU/L,两组差异有显著性意义(P<0.01)。结论：　检测单纯性肾病患儿血清甲状腺素水平,对增进治疗效果,估计和改善预后有比较重要的意义。     

儿童睡眠中癫癎性电持续状态的相关因素分析

目的：儿童睡眠中癫癎性电持续状态（ESES）的病因不明，该研究旨在分析ESES的相关因素，为有效预防和治疗此病提供依据。方法：以唐山市妇幼保健院2000年1月至2006年7月确诊为ESES的30例患儿为研究对象，选择与ESES组相匹配的非ESES癫癎组30例为对照组，设计问卷调查表获取资料。对癫癎发作类型、癫癎样放电起源部位、家族史及围生期情况、影像学、智商、癫癎综合征等多项因素采用χ2检验及t检验进行分析。结果：ESES组与对照组在癫癎家族史、智力低下及癫癎综合征、语言障碍之间比较差异有显著性（P<0.05）。癫癎发作类型、癫癎样放电起源部位、父母育龄、患儿出生史、热性惊厥家族史、影像学异常两组间差异均无显著性意义（P＞0.05）。既往患热性惊厥、脑瘫、颅内感染两组间比较，差异亦无显著性意义（P＞0.05）。结论：ESES与癫癎家族史、癫癎综合征、智力水平及语言障碍相关。［中国当代儿科杂志，2009，11（2）：110-112］     

Serum Cortisol and prolactin levels in childhood paroxysmal disorders

Postictal serum prolactin and Cortisol levels were measured in 37 children having either epilepsy, febrile seizure or syncopal attack and in 37 normal controls. Blood samples were obtained within 1.5 h following the seizure episode. All serum levels were compared between each group and the control groups. Significantly higher (P < 0.005) prolactin levels (56.64 ± 34.78 ng/mL) were found in the epileptic group, compared to the levels in children with febrile seizures (21.72 ± 12.92 ng/mL), syncope attacks (13.88 ± 5.27 ng/mL) and the control group (14.32 ± 5.05 ng/mL). In contrast, serum Cortisol levels were non-specifically elevated in children with epilepsy, febrile seizures and syncopal attacks. Cortisol secretion appears to be non-specifically elevated in all stressful events. Elevated prolactin levels may be helpful in differentiating epilepsy from febrile seizures and syncope.     

Serum prolactin and cortisol in children with some paroxysmal disorders

Postictal serum prolactin and cortisol levels were estimated in 73 children having either epilepsy, febrile seizures, breath-holding spells, or fever without other manifestation and in 20 normal controls. Mean serum prolactin levels (28.6±2.3 ng/ml) were significantly higher (p < 0.001) in the epileptic group than in the group with febrile seizures (12.7±2.8 ng/ml), non-specific febrile illness (12.2±2.4 ng/ml), breath-holding spells (8.8±1.1 ng/ml) and normal controls (9.8±2.6 ng/ml) Mean serum cortisol levels were non-specifically elevated in children with epilepsy (32.8±2.2 ug/dl), febrile convulsion (34.2±4.1 ug/dl) and non-specific febrile illness (30.6±2.4 ug/dl). Our observations suggest that elevated prolactin levels associated with afebrile epileptic seizures may help in differentiating epilepsy from febrile seizures and breath-holding spells. Cortisol levels appear to be non-specifically elevated in all stressful conditions.     

Prolactin and cortisol levels in various paroxysmal disorders in childhood

The hormonal response of the anterior pituitary to various epileptic and nonepileptic events in children was studied. Postictal serum prolactin and cortisol levels were measured in 17 children with epilepsy, 23 with febrile seizures, and 10 with syncope or breath-holding spells. The levels were compared with those of 30 children with nonspecific fever, and 23 afebrile children served as control subjects. Significantly higher (P less than .01) prolactin levels (26.5 +/- 3.3 ng/mL, mean +/- SEM) were found in the epileptic group, compared with levels in children with febrile seizures (13.2 +/- 1.0 ng/mL), fever (11.2 +/- 0.9 ng/mL), syncope (7.3 +/- 0.9 ng/mL), and the control group (7.9 +/- 0.6 ng/mL). In contrast, serum cortisol levels were nonspecifically elevated in the epileptics and patients with febrile seizures or fever only. These findings suggest that elevated prolactin levels may be found after epileptic seizures and much less after febrile seizures, but not after breath-holding spells or syncopal events. Cortisol secretion appears to be nonselectively triggered by all stressful events, such as epileptic and febrile seizures, and fever. Elevated prolactin levels (greater than 15 ng/mL) associated with seizures may help in differentiating epileptic from febrile seizures or syncope.     

反复发作热性惊厥患儿海马体积动态变化的临床研究

目的 分析反复发作热性惊厥患儿海马体积（HCV）的变化及意义。方法 回顾性选择34例热性惊厥反复发作且于2013年1月1日至2019年9月30日期间完善2次头部及海马磁共振平扫患儿的临床资料和检查结果。根据随访时间，分为第1次随访组和第2次随访组；根据预后，分为热性惊厥组、无热惊厥组和癫痫组。分析比较各组患儿HCV变化情况。结果 34例患儿总HCV与年龄呈正相关（r_s=0.683，P < 0.05）。第2次随访组总HCV大于第1次随访组（P < 0.05），两组学龄前患儿（年龄≥3岁）总HCV、左侧HCV、右侧HCV均大于婴幼儿患儿（年龄 < 3岁）（P < 0.05）。两组惊厥持续状态患儿总HCV平均每年增大值（△V）、左侧△V、右侧△V均小于非惊厥持续状态患儿（P < 0.05）。热性惊厥患儿、无热惊厥患儿及癫痫患儿总△V、左侧△V、右侧△V差异无统计学意义（P > 0.05）。结论 反复发作热性惊厥患儿的HCV随年龄增长逐渐增大，惊厥持续状态会损伤海马发育。     

年龄依赖性癫痫性脑病患儿的血清细胞因子变化

目的 探讨白细胞介素2(IL-2)、肿瘤坏死因子α (TNFα)和干扰素α (IFNα)在年龄依赖性癫痫性脑病(ADEE)患儿血清中的变化。方法 采用双抗体夹心酶联免疫吸附试验(ELISA)检测20例ADEE患儿血清中IL-2,TNFα和IFNα的水平,年龄和性别相匹配的20例正常儿童为对照组。结果 癫痫组血清IL-2,TNFα和IFNα水平均明显高于对照组分别为(379.53±44.86) ng/L比(239.66±21.03) ng/L;(962.42±107.69) ng/L比(501.62±38.93) ng/L;(586.12±84.86) ng/L比(329.56±30.43) ng/L。(t=2.59,3.51,2.71,P分别<0.05,0.01,0.05)。相关分析发现ADEE患儿血清IL-2与TNFα水平之间呈显著正相关(r=0.671,P<0.01)。结论 ADEE患儿存在免疫功能异常,细胞因子参与了免疫病理损害过程。     

Serum and cerebrospinal fluid zinc levels in children with febrile convulsions

The mechanisms underlying febrile convulsions (FC), which have multiple etiological factors, are not yet clear. The aim of the present study was to determine whether there were any changes in serum and cerebrospinal fluid (CSF) zinc (Zn) levels in children with febrile convulsion during seizures. A total of 102 children were included in the study, with four groups formed as follows: group A, 40 children with FC (aged 9 months to 5 years); group B, 20 children having fever without convulsion (aged 6 months to 5 years); group C, 20 children with afebrile convulsion (aged 6 months to 6 years) and group D, 22 healthy children (aged 5 months to 6 years). Serum and CSF zinc levels for groups A, B and C and serum Zn levels only for group D were measured. The serum Zn levels of 17 children in group A were again measured during healthy periods. Serum Zn levels of groups A, B, C and D had a mean of 0.70 ± 0.10 mg/dL, 1.07 ± 0.08 mg/dL, 1.26 ± 0.32 mg/dL and 1.17 ± 0.21 mg/dL, respectively, and the values of group A were lower than those of the other three groups (P < 0.001). In group B, serum Zn levels were also lower than those of groups C and D (P < 0.05). The CSF Zn levels of groups A, B and C were found to have a mean of 0.07 ± 0.02 mg/L, 0.12 ± 0.02 mg/L and 0.14 ± 0.04 mg/L, respectively. In group A, the CSF Zn levels were lower than those of groups B and C (P < 0.001), and in group B they were lower than those of group C (P < 0.05). For the 17 patients in group A, serum Zn levels during healthy periods (0.87 ±0.10 mg/dL) were found to be higher than the values shortly after seizures, but lower than those of groups B, C and D (P < 0.001). We could not observe any relationship between zinc levels of the serum and CSF and the degree and duration of the fever. These findings suggest that serum and CSF Zn levels decreased during infectious diseases, and that this decrease was more significant in patients with FC.     

Levels of Interleukin-8 and Tumor Necrosis Factor in the Cerebrospinal Fluid in Children with Purulent Meningitis and Viral Encephalitis

Ｒｅｃｅｎｔｓｔｕｄｉｅｓｈａｖｅｃｏｎｆｉｒｍｅｄｔｈａｔｔｈｅｒｅｉｓａｃｌｏｓｅｃｏｒｒｅｌａｔｉｏｎｂｅｔｗｅｅｎｔｈｅｎｅｒｖｏｕｓｓｙｓｔｅｍａｎｄｔｈｅｉｍｍｕｎｅｓｙｓｔｅｍ .Ｔｈｅｉｎｆｅｃｔｉｏｎｏｆｔｈｅｃｅｎｔｒａｌｎｅｒｖｏｕｓｓｙｓｔｅｍ (ＣＮＳ)ｍａｙｂｅａｃｃｏｍｐａｎｉｅｄｂｙｔｈｅｃｈａｎｇｅｏｆｃｙｔｏｋｉｎｅｓ.Ｔｈｅｇｏａｌｏｆｔｈｉｓｓｔｕｄｙｗａｓｔｏｄｅｔｅｃｔｔｈｅｌｅｖｅｌｓｏｆｉｎｔｅｒｌｅｕｋｉｎ 8(ＩＬ 8)ａｎｄｔｕｍｏｒｎｅｃｒｏｓｉｓｆａ…     

Role of early EEG and neuroimaging in determination of prognosis in children with complex febrile seizure

BACKGROUND: The present study investigates the role of early use of EEG in children with no known neuropathology prior to the first CFS, and the contribution made by computed tomography (CT) and magnetic resonance imaging (MRI) to treatment and prognosis. METHODS: Over a period of 7 years, the authors evaluated 159 children (age range: 2 months-5 years) who were being treated for CFS at Haydarpasa Numune Training and Research Hospital, Pediatrics Clinic, Istanbul, Turkey, and who had no previously known neurological disorder. Patients who presented with febrile seizure were determined to have CFS if they fulfilled the following criteria: <3 months of age when seizure occurred, duration of seizure >/=15 min, more than one seizure occurred during a single episode of illness, or focal seizures and postictal neurological deficit was found. EEG was performed on all patients. CT was performed on the patients who had postictal neurologic deficit or focal seizures. Cranial MRI was performed on patients who had focal findings in their EEGs. RESULTS: Electroencephalogram abnormality was found in 71 cases; 51 of these were diagnosed with epilepsy during follow up. Six of the 16 cases whose EEGs were abnormal between days 2 and 6 were diagnosed with epilepsy. Twenty of the 30 cases whose EEGs were abnormal between days 7 and 10 were diagnosed with epilepsy. All 25 cases who had abnormal EEGs after day 11 were diagnosed with epilepsy. CT was performed for 36 patients, of which five were found to have pathological changes. Pathological changes were detected in two of the nine patients who had cranial MRI. Patients who received CT or MRI were all diagnosed with epilepsy during follow up. CONCLUSION: The results suggest that if neurological examination of CFS patients are normal after their clinical status has stabilised, EEG should be performed after 7 days at the earliest, however for the most accurate diagnosis EEG should be performed 10 days after CFS. The most important predictor for neuroimaging was found to be detection of postictal neurologic deficit. MRI had no advantages over CT in first treating CFS in the emergency unit.     

Epilepsy and mental retardation following febrile seizures in childhood

In an unselected group of children who were seen following an initial febrile convulsion, the frequency of subsequent afebrile seizures was 3.5% and of mental retardation 1%. The most common afebrile seizure type was generalized major (86%). About 3/4 of the children who developed afebrile seizures did so by three years and all by five years following the initial febrile seizure. The children with afebrile seizures differed from those without afebrile seizures in the frequency of neonatal abnormality, family history of mental retardation, focal initial febrile convulsions, and delay in psychomotor milestones before the initial febrile seizure. Only about 1/3 of the children who developed afebrile seizures ever had a recurrent febrile convulsion and none had complex recurrent febrile seizures. Half the children with mental retardation had histories of delay in psychomotor milestones prior to the initial febrile seizure, and no child with mental retardation had any seizure longer than five minutes. The administration of daily phenobarbital did not reduce the frequency of epilepsy, in spite of a significant reduction in the incidence of recurrent febrile seizures. There remains no evidence that the prevention of recurrent febrile convulsions significantly decreases the frequency of afebrile seizures or mental retardation.