MRI abnormalities following febrile status epilepticus in children: The FEBSTAT study

Shlomo Shinnar, Jacqueline A. Bello, Stephen Chan, Dale C. Hesdorffer, Darrell V. Lewis, James MacFall, John M. Pellock, Douglas R. Nordli, L. Matthew Frank, Solomon L. Moshe, William Gomes, Ruth C. Shinnar, Shumei Sun

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Abstract

Objective: The FEBSTAT study is a prospective study that seeks to determine the acute and long-term consequences of febrile status epilepticus (FSE) in childhood. Methods: From 2003 to 2010, 199 children age 1 month to 5 years presenting with FSE (>30 minutes) were enrolled in FEBSTAT within 72 hours of the FSE episode. Of these, 191 had imaging with emphasis on the hippocampus. All MRIs were reviewed by 2 neuroradiologists blinded to clinical details. A group of 96 children with first simple FS who were imaged using a similar protocol served as controls. Results: A total of 22 (11.5%) children had definitely abnormal (n = 17) or equivocal (n = 5) increased T2 signal in the hippocampus following FSE compared with none in the control group (p < 0.0001). Developmental abnormalities of the hippocampus were more common in the FSE group (n = 20, 10.5%) than in controls (n = 2, 2.1%) (p < 0.0097) with hippocampal malrotation being the most common (15 cases and 2 controls). Extrahippocampal imaging abnormalities were present in 15.7% of the FSE group and 15.6% of the controls. However, extrahippocampal imaging abnormalities of the temporal lobe were more common in the FSE group (7.9%) than in controls (1.0%) (p = 0.015). Conclusions: This prospective study demonstrates that children with FSE are at risk for acute hippocampal injury and that a substantial number also have abnormalities in hippocampal development. Follow-up studies are in progress to determine the long-term outcomes in these children.

Original languageEnglish (US)
Pages (from-to)871-877
Number of pages7
JournalNeurology
Volume79
Issue number9
DOIs
StatePublished - Aug 28 2012

ASJC Scopus subject areas

  • Clinical Neurology

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    Shinnar, S., Bello, J. A., Chan, S., Hesdorffer, D. C., Lewis, D. V., MacFall, J., Pellock, J. M., Nordli, D. R., Frank, L. M., Moshe, S. L., Gomes, W., Shinnar, R. C., & Sun, S. (2012). MRI abnormalities following febrile status epilepticus in children: The FEBSTAT study. Neurology, 79(9), 871-877. https://doi.org/10.1212/WNL.0b013e318266fcc5