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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.
GLOSSARY
- CI=
- confidence interval;
- DWI=
- diffusion-weighted imaging;
- ETL=
- echo train length;
- FOV=
- field of view;
- FS=
- febrile seizures;
- FSE=
- febrile status epilepticus;
- HIMAL=
- hippocampal malrotation;
- HS=
- hippocampal sclerosis;
- IQR=
- interquartile range;
- MTLE=
- mesial temporal lobe epilepsy;
- TE=
- echo time;
- TR=
- repetition time
Footnotes
Study funding: Supported by NINDS grant NS43209 (PI S. Shinnar, MD, PhD) and NICHD grant 36867 (PI D.C. Hesdorffer, PhD).
Editorial, page 840
Supplemental data at www.neurology.org
FEBSTAT coinvestigators and contributors are listed on the Neurology® Web site at www.neurology.org.
- Received February 4, 2012.
- Accepted April 19, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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- MRI peri-ictal abnormalities in febrile status epilepticus. Cause or consequence?
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