Question

All of the following factors are associated with a substantially greater risk of developing epilepsy after febrile seizures, except:

• A. Complex febrile seizures
• B. Early age of onset
• C. Developmental abnormalities
• D. Positive family history of epilepsy

Hint:

Separate the risk of recurrence from the risk of true epilepsy; early onset predicts recurrence.

Answer 1

The Correct Option is B

Step 1: The question separates two different risks. One is the risk that febrile seizures will simply recur, and the other is the risk of going on to develop true epilepsy (afebrile seizures). This question is about the risk of later epilepsy.
Step 2: The established risk factors for developing epilepsy after a febrile seizure are: complex (atypical) febrile seizures, a family history of epilepsy, and neurodevelopmental abnormalities present before the seizure. These three are the textbook predictors.
Step 3: Early age of onset is a risk factor for recurrence of febrile seizures, not for developing later epilepsy. So it is the exception in this question, and the printed key of B is correct.
Step 4: Confirming the others. Complex febrile seizures (prolonged, focal, or more than one in 24 hours) raise the epilepsy risk. A positive family history of epilepsy raises it. Pre-existing developmental abnormalities raise it. All three belong on the list, so they are not the exception.
Step 5: The factor not linked to a substantially greater risk of epilepsy is early age of onset.
Answer: Option B, Early age of onset.