Effects of Oral Steroid Therapy on Prevention of Recurrence of Febrile Seizures in Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis Syndrome

Purpose: This study aimed to investigate the occurrence rate of febrile seizures in patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome and to evaluate the effect of steroid treatment on febrile seizure recurrence.Methods: Patients diagnosed with PFAPA syndrome at a single tertiary center between 2011 and 2023 were included. Demographic data and febrile seizure history were obtained through a retrospective review of medical records. Oral steroid treatment was administered to 56.7% (72/127) of patients based on the individual clinical course, and its effect on febrile seizure recurrence was evaluated.Results: A total of 127 patients with PFAPA syndrome were included, and the occurrence rate of febrile seizures was 20.4% (26/127). Of the 26 patients with febrile seizures, 15 (57.7%) received steroid treatment, and the mean number of previous febrile seizure episodes was 3.5±3.5. After steroid treatment, 12 of 15 patients (80.0%) had no further febrile seizures, whereas three of 15 (20.0%) displayed an improvement with only one additional febrile seizure.Conclusion: The occurrence of febrile seizures was higher in patients with PFAPA syndrome than in the general population. However, febrile seizure recurrence may be substantially reduced with appropriate oral steroid treatment. Therefore, accurate diagnosis of PFAPA syndrome and appropriate steroid treatment may help reduce recurrent febrile seizures.