Acute EEG findings in children with febrile status epilepticus: Results of the FEBSTAT study

Douglas R. Nordli, Solomon L. Moshé, Shlomo Shinnar, Dale C. Hesdorffer, Yoshimi Sogawa, John M. Pellock, Darrell V. Lewis, L. Matthew Frank, Ruth C. Shinnar, Shumei Sun

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Abstract

Objective: The FEBSTAT (Consequences of Prolonged Febrile Seizures) study is prospectively addressing the relationships among serial EEG, MRI, and clinical follow-up in a cohort of children followed from the time of presentation with febrile status epilepticus (FSE). Methods: We recruited 199 children with FSE within 72 hours of presentation. Children underwent a detailed history, physical examination, MRI, and EEG within 72 hours. All EEGs were read by 2 teams and then conferenced. Associations with abnormal EEG were determined using logistic regression. Interrater reliability was assessed using the k statistic. Results: Of the 199 EEGs, 90 (45.2%) were abnormal with the most common abnormality being focal slowing (n = 47) or attenuation (n = 25); these were maximal over the temporal areas in almost all cases. Epileptiform abnormalities were present in 13 EEGs (6.5%). In adjusted analysis, the odds of focal slowing were significantly increased by focal FSE (odds ratio [OR] = 5.08) and hippocampal T2 signal abnormality (OR = 3.50) and significantly decreased with high peak temperature (OR = 0.18). Focal EEG attenuation was also associated with hippocampal T2 signal abnormality (OR = 3.3). Conclusions: Focal EEG slowing or attenuation are present in EEGs obtainedwithin 72 hours of FSE in a substantial proportion of children and are highly associated with MRI evidence of acute hippocampal injury. These findings may be a sensitive and readily obtainable marker of acute injury associated with FSE.

Original languageEnglish (US)
Pages (from-to)2180-2186
Number of pages7
JournalNeurology
Volume79
Issue number22
DOIs
StatePublished - Nov 27 2012

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ASJC Scopus subject areas

  • Clinical Neurology

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Nordli, D. R., Moshé, S. L., Shinnar, S., Hesdorffer, D. C., Sogawa, Y., Pellock, J. M., Lewis, D. V., Frank, L. M., Shinnar, R. C., & Sun, S. (2012). Acute EEG findings in children with febrile status epilepticus: Results of the FEBSTAT study. Neurology, 79(22), 2180-2186. https://doi.org/10.1212/WNL.0b013e3182759766