***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Several disorders have been attributed to  measles-mumps-rubella ( MMR ) vaccination  during the past decade . The aim of this prospect i ve follow-up study was to identify serious adverse events causally related to MMR vaccination . METHODS When the MMR vaccination program was launched in Finl and in 1982 , a countrywide surveillance system was set up to detect serious adverse events associated with MMR . To obtain detailed case histories vaccinees ' clinical charts were review ed . Serum sample s were analyzed to trace concurrent infections . SETTING All hospitals and health centers in Finl and from 1982 through 1996 . RESULTS Immunization of 1.8 million individuals and consumption of almost 3 million vaccine doses by the end of 1996 gave rise to 173 potentially serious reactions cl aim ed to have been caused by MMR vaccination . In all , 77 neurologic , 73 allergic and 22 miscellaneous reactions and 1 death  were reported , febrile seizure being the most common event . However , 45 % of these events proved to be probably caused or contributed by some other factor , giving an incidence of serious adverse events with possible or indeterminate causal relation with MMR vaccination of 5.3 per 100,000 vaccinees or 3.2 per 100,000 vaccine doses . CONCLUSIONS Causality between immunization and a subsequent untoward event can not be estimated solely on the basis of a temporal relation . Comprehensive analysis of the reported adverse reactions established that serious events causally related to MMR vaccine are rare and greatly outweighed by the risks of natural MMR diseases Background : Febrile seizures affect 2 to 4 % of children , and 2 to 10 % develop subsequent unprovoked seizures . Secondary analyses of two large cohorts identified neurodevelopmental abnormalities , complex febrile seizures , and a family history of epilepsy as predictors of unprovoked seizures . We present an analysis of children prospect ively followed from their first febrile seizure  to reassess these three factors , examine factors of equivocal importance , and assess the importance of some new factors that we identified as predictors of recurrent febrile seizures . Methods : Children ( N = 428 ) were prospect ively identified for a first febrile seizure through pediatric emergency departments of four hospitals . Information was collected from medical records and interviews with parents . Children were followed for 2 years or more . Results : Unprovoked seizures occurred in 26 ( 6 % ) . Neurodevelopmental abnormalities , complex febrile seizures , and a family history of epilepsy were associated with an increased risk of unprovoked seizures . Recurrent febrile seizures and brief duration of fever before the initial febrile seizure were also risk factors . A family history of febrile seizures , temperature and age at the initial febrile seizure , sex , and race were not associated with unprovoked seizures . Conclusions : We confirmed the increased risk associated with traditionally accepted predictors of epilepsy following febrile seizures . Also , the risk clearly increased with recurrent febrile seizures . In general , predictors of subsequent unprovoked seizures differ from predictors of recurrent febrile seizures . One notable exception , brief duration of fever before the initial febrile seizure , predicts both types of outcome and may be a marker for an increased susceptibility to seizures . NEUROLOGY 1996;47 : 562 - Visual inspection and volumetric analysis of MRIs allow mesial temporal sclerosis ( MTS ) to be reliably identified in patients with temporal lobe epilepsy . The presence of unilateral MTS ipsilateral to the side of habitual seizure onset is an indicator for the prognosis of good outcome after temporal lobe resection . There is evidence to suggest that widespread temporal lobe pathology , leading to atrophy , may be associated with MTS and such abnormal tissue may play an important role in epileptogenesis . We have analysed quantitatively the volumes of the mesial and lateral temporal lobe substructures in MRIs from 62 patients with intractable mesial temporal lobe epilepsy and in 20 normal controls . We found significant atrophy in these structures in patients , ranging from 8.3 to 18.4 % compared with controls . The degree of atrophy in the extrahippocampal structures correlated with the degree of hippocampal atrophy , suggesting that a common process may be responsible . There was no correlation between the degree of atrophy in the extrahippocampal structures and the duration of epilepsy , a history of febrile convulsions or of generalized seizures . These findings suggest that there may be widespread pathological abnormalities in the temporal lobe associated with MTS . The importance of extrahippocampal atrophy to surgical outcome and whether it occurs in temporal lobe epilepsy not associated with MTS remain to be investigated A cohort of 92 children with an initial febrile convulsion ( FC ) , prospect ively identified in a community-based study 1985 - 1987 , was compared with a cohort of 185 age- and sex-matched referents from the same study area . The median time of follow-up was 6.7 years ( range : 5.7 - 7.7 ) and the median age at follow-up was 8.3 years ( range 6.5 - 14 ) . The cases had their first FC at a median age of 18 months ( range 5 - 67 months ) , their second FC at 24 months ( 11 - 108 months ) and their third FC at 26 months ( 13 - 92 months ) . FC recurred in 42 % of the FC cohort , and 3.8 % of the children in the referent cohort experienced FC . Single or recurrent afebrile seizures occurred in 4.3 % and epilepsy in 3.3 % of the FC cohort , while no afebrile seizures occurred in the referent cohort . The risk of having a sibling with FC was three times ( 95 % confidence interval 1.3 - 6.2 ) higher in the FC cohort , while there was no difference between the cohorts in the risk of siblings developing afebrile seizures . There was no difference between the cohorts in the utilization of health services during the follow-up period . Two children in the FC cohort went to a school for the mentally retarded . There was no aetiological relationship between the FC and the mental retardation in these cases . All other children attended normal schools and none needed remedial instruction Abstract Objective : To compare the safety and efficacy of midazolam given intranasally with diazepam given intravenously in the treatment of children with prolonged febrile seizures . Design : Prospect i ve r and omised study . Setting : Paediatric emergency department in a general hospital . Subjects : 47 children aged six months to five years with prolonged febrile seizure ( at least 10 minutes ) during a 12 month period . Interventions : Intranasal midazolam ( 0.2 mg/kg ) and intravenous diazepam ( 0.3 mg/kg ) . Main outcome measures : Time from arrival at hospital to starting treatment and cessation of seizures . Results : Intranasal midazolam and intravenous diazepam were equally effective . Overall , 23 of 26 seizures were controlled with midazolam and 24 out of 26 with diazepam . The mean time from arrival at hospital to starting treatment was significantly shorter in the midazolam group ( 3.5 ( SD 1.8 ) minutes , 95 % confidence interval 3.3 to 3.7 ) than the diazepam group ( 5.5 ( 2.0 ) , 5.3 to 5.7 ) . The mean time to control of seizures was significantly sooner ( 6.1 ( 3.6 ) , 6.3 to 6.7 ) in the midazolam group than the diazepam group ( 8.0 ( 0.5 ) , 7.9 to 8.3 ) . No significant side effects were observed in either group . Conclusion : Seizures were controlled more quickly with intravenous diazepam than with intranasal midazolam , although midazolam was as safe and effective as diazepam . The overall time to cessation of seizures after arrival at hospital was faster with intranasal midazolam than with intravenous diazepam . The intranasal route can possibly be used not only in medical centres but in general practice and , with appropriate instructions , by families of children with recurrent febrile seizures at home In order to evaluate the effectiveness of diazepam for the reduction in the recurrence of febrile seizures we carried out a prospect i ve study in two groups of children ; Group A : 45 children ( 25 female , 20 male ) , receiving oral prophylaxis with diazepam , and Group B : 65 children ( 35 female , 30 male ) who did not receive any oral prophylaxis . All subjects of both groups were followed for at least 4 years and finally re-evaluated at the mean age of 6.7+/-1.4 years . Among the patients of Group A , recurrent febrile seizures ( FS ) occurred in five of the 45 children ( 11.1 % ) . Among the 65 children of Group B , 20 ( 30.7 % ) went on to have one or more additional episodes . In conclusion , our study demonstrates that oral diazepam , given only when fever is present , is an effective means of reducing the risk of recurrences of FS Febrile status epilepticus ( SE ) represents the extreme end of the complex febrile seizure spectrum . If there are significant sequelae to febrile seizures , they should be more common in this group . We have prospect ively identified 180 children aged 1 month to 10 years who presented with febrile SE over a 10-year period in Bronx , New York , and Richmond , Virginia . They were compared with 244 children who presented with their first febrile seizure ( not SE ) in a prospect i ve study done in the Bronx . The mean age of the children with febrile SE was 1.92 years , and of the comparison group , 1.85 years .  Duration of SE was 30 - 59 min in 103 ( 58 % ) , 60 - 119 min in 43 ( 24 % ) , and > or = 120 min in 34 ( 18 % ) . Focal features were present in 64 ( 35 % ) of cases . There were no deaths and no cases of new cognitive or motor h and icap .  Children with febrile SE were more likely to be neurologically abnormal ( 20 % vs. 5 % ; p < 0.001 ) , to have a history of neonatal seizures ( 3 % vs. 0 ; p = 0.006 ) and a family history of epilepsy ( 11 % vs. 5 % ; p = 0.05 ) and less likely to have a family history of febrile seizures ( 15 % vs. 27 % ; p = 0.01 ) than were children in the comparison group . The short-term morbidity and mortality of febrile SE are low . There are differences in the types of children who have febrile SE compared with those who experience briefer febrile seizures . Long-term follow-up of this cohort may provide insight into the relationship of prolonged febrile seizures and subsequent mesial temporal sclerosis Summary : Purpose : A prospect i ve population ‐based case‐control study was performed to ascertain whether febrile convulsion ( FC ) in early childhood is associated with neurocognitive attention deficits in school age We report a 12-year follow-up study of children with febrile convulsions ( FCs ) . The National General Practice Study of Epilepsy ( NGPSE ) is a large prospect i ve community-based cohort study of 1,195 patients of all ages from first presentation with an identified seizure . Two hundred and twenty children with a first febrile convulsion were identified from the above study between 1984 and 1987 . Children were prospect ively followed up to ascertain subsequent seizures , neurological problems and treatment .  Two hundred and seven patients were followed for a minimum of 8.4 years ( median 11.2 years ) . In the FC cohort , 6 % of the children developed subsequent epilepsy , which compares with a population risk of about 1.4 % . Ten percent had neurological sequelae . Eleven percent of the children had received medication to prevent recurrence of FC , and in one third of these cases , this was for simple FCs . Using a time-dependent covariate Cox proportional hazards model , the number of FCs was associated with an increased risk of epilepsy ( hazard ratio 2.48 ; 95 % confidence limits , CL 1.68 , 3.65 ) up to a limit of 4 . A statistically significant association between occurrence of complex FC and subsequent epilepsy was not found , but a review of other studies quantified the odds ratio for epilepsy after a complex first FC as 3.4 ( 95 % CL 2.1 , 5.4 ) . Epilepsy is a significant if infrequent sequel to FCs . Factors associated with subsequent epilepsy are the number of FCs or a complex first FC . Overtreatment of this condition continues Interictal diffusion imaging studies in patients with medial temporal lobe epilepsy ( MTLE ) accompanied by hippocampal sclerosis ( HS ) have shown an increased diffusivity in the epileptogenic hippocampus . In this study , we wanted to explore the whole brain in order to determine if MTLE could have an impact on the organization and the architecture of a large cerebral network and to identify clinical factors that could mediate diffusion abnormalities . Diffusion tensor imaging ( DTI ) and statistical parametric mapping of the entire brain were performed in 35 well-defined MTLE patients and in 36 healthy volunteers . SPM analyses identified three abnormal areas : an increased diffus 
    Output:
    
We found that simple febrile seizures do not carry a risk of death , but there is a very small risk of death after complex febrile seizures ( CFSs ) , particularly febrile status epilepticus .
There is no evidence that SUDEP ( sudden unexpected death in epilepsy ) occurs in association with febrile seizures .
There is no evidence of any risk of hippocampal or mesial temporal sclerosis ( HS/MTS ) in association with simple febrile seizures .