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Febrile infection-related epilepsy syndrome (FIRES): does duration of anesthesia affect outcome?

Uri Kramer1, Ching-Shiang Chi, Kuang-Lin Lin

  • 1Pediatric Epilepsy Unit, Tel Aviv Sourasky Medical Center, Tel Aviv University, 6 Weitzman Street, Tel Aviv, Israel. umkramer@netvision.net.il

Epilepsia
|October 5, 2011
PubMed

Insights

This study found that inducing burst-suppression coma (BSC) in children with febrile infection-related epilepsy syndrome (FIRES) correlated with poorer cognitive outcomes. Longer BSC durations were linked to worse cognitive levels in these epilepsy patients.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Critical Care Medicine

Background:

  • Febrile infection-related epilepsy syndrome (FIRES) is a severe condition characterized by prolonged refractory status epilepticus in children.
  • Burst-suppression coma (BSC) is a therapeutic option used in managing refractory status epilepticus.
  • The long-term impact of BSC on neurological outcomes in FIRES patients remains an area of concern.

Purpose of the Study:

  • To investigate the correlation between induced burst-suppression coma (BSC) and patient outcomes in febrile infection-related epilepsy syndrome (FIRES).
  • To analyze the relationship between the duration of BSC and cognitive function at follow-up in pediatric FIRES patients.

Main Methods:

  • A retrospective multicenter study was conducted, analyzing data from eight studies published between November 2001 and July 2010.
  • Seventy-seven children diagnosed with FIRES and prolonged refractory status epilepticus were included.
  • Data on induced BSC and cognitive assessments at follow-up were collected and analyzed.

Main Results:

  • Out of 77 enrolled patients, BSC was induced in 46.
  • A significant association was found between the duration of BSC and cognitive levels at follow-up (p=0.005).
  • Patients treated with induced prolonged BSC demonstrated a worse cognitive outcome compared to those without or with shorter BSC durations.

Conclusions:

  • The overall outcome for patients with FIRES is generally poor.
  • Inducing a prolonged burst-suppression coma as a treatment for FIRES is associated with adverse cognitive outcomes.
  • Further research is needed to optimize treatment strategies for FIRES to improve long-term neurological recovery.

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