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To the Editor:
In a recent article, it was concluded that prolonged febrile convulsion (PFC) does not cause either neurologic sequelae or brain damage,1 particularly mesial temporal sclerosis (MTS). This is an extremely strong epidemiologic statement that has been made on the basis of follow-up of only 24 patients who had a PFC. Although that study confirms that MTS is not inevitable following PFC, in order to define the prevalence of MTS in a population that has had PFC, a much larger dataset would be required. In addition, the authors have not discussed their results in the context of the large animal model literature supporting the view that prolonged seizures can cause hippocampal injury consistent with MTS.
The hippocampal injury associated with PFC may encompass a spectrum from subtle neuronal injury to MTS. Studies that have reported hippocampal abnormalities, consistent with hippocampal edema, within a few days of PFC have concluded that PFC could …
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