TY - JOUR
T1 - Phenomenology of prolonged febrile seizures
T2 - Results of the FEBSTAT study
AU - Shinnar, S.
AU - Hesdorffer, D. C.
AU - Nordli, D. R.
AU - Pellock, J. M.
AU - O'Dell, C.
AU - Lewis, D. V.
AU - Frank, L. M.
AU - Moshé, S. L.
AU - Epstein, L. G.
AU - Marmarou, A.
AU - Bagiella, E.
N1 - Funding Information:
Supported by grant NS 43209 from NINDS (PI: S. Shinnar).
PY - 2008/7/15
Y1 - 2008/7/15
N2 - Background: Febrile status epilepticus (FSE) has been associated with hippocampal injury and subsequent mesial temporal sclerosis and temporal lobe epilepsy. However, little is known about the semiology of FSE. Methods: A prospective, multicenter study of the consequences of FSE included children, aged 1 month through 5 years, presenting with a febrile seizure lasting 30 minutes or more. Procedures included neurologic history and examination and an MRI and EEG within 72 hours. All information related to seizure semiology was reviewed by three epileptologists blinded to MRI and EEG results and to subsequent outcome. Inter-rater reliability was assessed by the κ statistic. Results: Among 119 children, the median age was 1.3 years, the mean peak temperature was 103.2°F, and seizures lasted a median of 68.0 minutes. Seizure duration followed a Weibull distribution with a shape parameter of 1.68. Seizures were continuous in 52% and behaviorally intermittent (without recovery in between) in 48%; most were partial (67%) and almost all (99%) were convulsive. In one third of cases, FSE was unrecognized in the emergency department. Of the 119 children, 86% had normal development, 24% had prior febrile seizures, and family history of febrile seizures in a first-degree relative was present in 25%. Conclusions: Febrile status epilepticus is usually focal and often not well recognized. It occurs in very young children and is usually the first febrile seizure. Seizures are typically very prolonged and the distribution of seizure durations suggests that the longer a seizure continues, the less likely it is to spontaneously stop.
AB - Background: Febrile status epilepticus (FSE) has been associated with hippocampal injury and subsequent mesial temporal sclerosis and temporal lobe epilepsy. However, little is known about the semiology of FSE. Methods: A prospective, multicenter study of the consequences of FSE included children, aged 1 month through 5 years, presenting with a febrile seizure lasting 30 minutes or more. Procedures included neurologic history and examination and an MRI and EEG within 72 hours. All information related to seizure semiology was reviewed by three epileptologists blinded to MRI and EEG results and to subsequent outcome. Inter-rater reliability was assessed by the κ statistic. Results: Among 119 children, the median age was 1.3 years, the mean peak temperature was 103.2°F, and seizures lasted a median of 68.0 minutes. Seizure duration followed a Weibull distribution with a shape parameter of 1.68. Seizures were continuous in 52% and behaviorally intermittent (without recovery in between) in 48%; most were partial (67%) and almost all (99%) were convulsive. In one third of cases, FSE was unrecognized in the emergency department. Of the 119 children, 86% had normal development, 24% had prior febrile seizures, and family history of febrile seizures in a first-degree relative was present in 25%. Conclusions: Febrile status epilepticus is usually focal and often not well recognized. It occurs in very young children and is usually the first febrile seizure. Seizures are typically very prolonged and the distribution of seizure durations suggests that the longer a seizure continues, the less likely it is to spontaneously stop.
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U2 - 10.1212/01.wnl.0000310774.01185.97
DO - 10.1212/01.wnl.0000310774.01185.97
M3 - Article
C2 - 18525033
AN - SCOPUS:48449093210
SN - 0028-3878
VL - 71
SP - 170
EP - 176
JO - Neurology
JF - Neurology
IS - 3
ER -