Fevers and Seizures in Children

Febrile status epilepticus can injure brain in children and may lead to epilepsy

(RxWiki News) Moms and dads know that an occasional childhood fever is normal. But a fever that is accompanied by a seizure isn't normal - it's a serious problem which can have long term consequences.

A recent study looked at the short term and long term affects of childhood febrile status epilepticus (FSE), seizures that last for more than 30 minutes and occur during a high fever. The study found that FSE can injure the brain in some children.

"Seek medical attention for childhood seizures"

Schlomo Shinner, MD, PhD, of Albert Einstein College of Medicine in New York City and colleagues examined data of 199 children with FSE. The children's ages ranged between 1 month to 5 years. The data was gathered between 2003 and 2010 through the Consequences of Febrile Seizures in Childhood (FEBSTAT) study. FEBSTAT is a multi-center study that investigates a possible link between FSE and temporal lobe epilepsy.

One-hundred and ninety-one children with FSE underwent imaging that focused on the hippocampus, blood tests and neurological exams. This data was compared to the data of 96 controls. The controls were aged 6 months to 5 years and first had a febrile seizure (FS) between March 1999 and April 2004. A FS is a seizure caused by fever when there is no evidence of prior non-fever related seizures or central nervous system infection.

The imaging tools used were magnetic resonance imaging (MRI) and electroencephalography (EEG).

MRI uses a magnetic field and pulses of radio wave energy to create visuals of internal organs. EEG records brain activity through sensors on the scalp and is often used to diagnose epilepsy.

The MRI showed that 11.5 percent of the children with FSE also had signs of injury to the hippocampus and 10.5 percent had developmental abnormalities.

This damage was rarely seen in the control group. Only 2.1 percent of the control group had developmental abnormalities and there were no brain injuries. The EEG results in 45.2 percent of the children with FSE were abnormal. A short term brain injury after FSE doubled the likelihood of an abnormal EEG.

This study showed that brain injury, abnormal brain anatomy or activity can occur within days of FSE. Many who experience FSE may already have abnormalities that have made them more susceptible to the condition.

Studies are in progress to determine the long-term consequences of FSE, including whether it leads to epilepsy. The authors hope that MRI and EEG will one day be used to determine risk of epilepsy in children following febrile seizures.

Two papers were published online in Neurology that cover the study. Dr. Shinnar is funded by National Institutes of Health (NIH) grants and has associations with King Pharmaceuticals, Questcor, Sunovion Eisai, Neuronex, UCB.

Several authors reported direct and indirect financial connections and/or consultancy work with over a dozen different pharmaceutical companies. They also reported links to various hospitals and medical associations and have worked as experts on medico-legal cases.

Review Date: 
November 27, 2012