Human herpesvirus 6 and 7 in febrile status epilepticus

The FEBSTAT study

Leon G. Epstein, Shlomo Shinnar, Dale C. Hesdorffer, Douglas R. Nordli, Aaliyah Hamidullah, Emma K T Benn, John M. Pellock, L. Matthew Frank, Darrell V. Lewis, Solomon L. Moshe, Ruth C. Shinnar, Shumei Sun

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Purpose: In a prospective study, Consequences of Prolonged Febrile Seizures in Childhood (FEBSTAT), we determined the frequency of human herpesvirus (HHV)-6 and HHV-7 infection as a cause of febrile status epilepticus (FSE). Methods: Children ages 1 month to 5 years presenting with FSE were enrolled within 72 h and received a comprehensive assessment including specimens for HHV-6 and HHV-7. The presence of HHV-6A, HHV-6B, or HHV-7 DNA and RNA (amplified across a spliced junction) determined using quantitative polymerase chain reaction (qPCR) at baseline indicated viremia. Antibody titers to HHV-6 and HHV-7 were used in conjunction with the PCR results to distinguish primary infection from reactivated or prior infection Key Findings: Of 199 children evaluated, HHV-6 or HHV-7 status could be determined in 169 (84.9%). HHV-6B viremia at baseline was found in 54 children (32.0%), including 38 with primary infection and 16 with reactivated infection. No HHV-6A infections were identified. HHV-7 viremia at baseline was observed in 12 children (7.1%), including eight with primary infection and four with reactivated infection. Two subjects had HHV-6/HHV-7 primary coinfection at baseline. There were no differences in age, characteristics of illness or fever, seizure phenomenology or the proportion of acute EEG or imaging abnormalities in children presenting with FSE with or without HHV infection. Significance: HHV-6B infection is commonly associated with FSE. HHV-7 infection is less frequently associated with FSE. Together, they account for one third of FSE, a condition associated with an increased risk of both hippocampal injury and subsequent temporal lobe epilepsy.

Original languageEnglish (US)
Pages (from-to)1481-1488
Number of pages8
JournalEpilepsia
Volume53
Issue number9
DOIs
StatePublished - Sep 2012

Fingerprint

Human Herpesvirus 7
Human Herpesvirus 6
Status Epilepticus
Fever
Herpesviridae Infections
Viremia
Infection
Febrile Seizures
Polymerase Chain Reaction
Temporal Lobe Epilepsy
Coinfection
Electroencephalography

Keywords

  • Febrile seizures
  • Human herpesvirus
  • Mesial temporal sclerosis
  • Status epilepticus

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Epstein, L. G., Shinnar, S., Hesdorffer, D. C., Nordli, D. R., Hamidullah, A., Benn, E. K. T., ... Sun, S. (2012). Human herpesvirus 6 and 7 in febrile status epilepticus: The FEBSTAT study. Epilepsia, 53(9), 1481-1488. https://doi.org/10.1111/j.1528-1167.2012.03542.x

Human herpesvirus 6 and 7 in febrile status epilepticus : The FEBSTAT study. / Epstein, Leon G.; Shinnar, Shlomo; Hesdorffer, Dale C.; Nordli, Douglas R.; Hamidullah, Aaliyah; Benn, Emma K T; Pellock, John M.; Frank, L. Matthew; Lewis, Darrell V.; Moshe, Solomon L.; Shinnar, Ruth C.; Sun, Shumei.

In: Epilepsia, Vol. 53, No. 9, 09.2012, p. 1481-1488.

Research output: Contribution to journalArticle

Epstein, LG, Shinnar, S, Hesdorffer, DC, Nordli, DR, Hamidullah, A, Benn, EKT, Pellock, JM, Frank, LM, Lewis, DV, Moshe, SL, Shinnar, RC & Sun, S 2012, 'Human herpesvirus 6 and 7 in febrile status epilepticus: The FEBSTAT study', Epilepsia, vol. 53, no. 9, pp. 1481-1488. https://doi.org/10.1111/j.1528-1167.2012.03542.x
Epstein LG, Shinnar S, Hesdorffer DC, Nordli DR, Hamidullah A, Benn EKT et al. Human herpesvirus 6 and 7 in febrile status epilepticus: The FEBSTAT study. Epilepsia. 2012 Sep;53(9):1481-1488. https://doi.org/10.1111/j.1528-1167.2012.03542.x
Epstein, Leon G. ; Shinnar, Shlomo ; Hesdorffer, Dale C. ; Nordli, Douglas R. ; Hamidullah, Aaliyah ; Benn, Emma K T ; Pellock, John M. ; Frank, L. Matthew ; Lewis, Darrell V. ; Moshe, Solomon L. ; Shinnar, Ruth C. ; Sun, Shumei. / Human herpesvirus 6 and 7 in febrile status epilepticus : The FEBSTAT study. In: Epilepsia. 2012 ; Vol. 53, No. 9. pp. 1481-1488.
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abstract = "Purpose: In a prospective study, Consequences of Prolonged Febrile Seizures in Childhood (FEBSTAT), we determined the frequency of human herpesvirus (HHV)-6 and HHV-7 infection as a cause of febrile status epilepticus (FSE). Methods: Children ages 1 month to 5 years presenting with FSE were enrolled within 72 h and received a comprehensive assessment including specimens for HHV-6 and HHV-7. The presence of HHV-6A, HHV-6B, or HHV-7 DNA and RNA (amplified across a spliced junction) determined using quantitative polymerase chain reaction (qPCR) at baseline indicated viremia. Antibody titers to HHV-6 and HHV-7 were used in conjunction with the PCR results to distinguish primary infection from reactivated or prior infection Key Findings: Of 199 children evaluated, HHV-6 or HHV-7 status could be determined in 169 (84.9{\%}). HHV-6B viremia at baseline was found in 54 children (32.0{\%}), including 38 with primary infection and 16 with reactivated infection. No HHV-6A infections were identified. HHV-7 viremia at baseline was observed in 12 children (7.1{\%}), including eight with primary infection and four with reactivated infection. Two subjects had HHV-6/HHV-7 primary coinfection at baseline. There were no differences in age, characteristics of illness or fever, seizure phenomenology or the proportion of acute EEG or imaging abnormalities in children presenting with FSE with or without HHV infection. Significance: HHV-6B infection is commonly associated with FSE. HHV-7 infection is less frequently associated with FSE. Together, they account for one third of FSE, a condition associated with an increased risk of both hippocampal injury and subsequent temporal lobe epilepsy.",
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