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

Shlomo Shinnar1, Jacqueline A Bello, Stephen Chan

  • 1Neurology and Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. sshinnar@aol.com

Neurology
|July 31, 2012
PubMed

Insights

Febrile status epilepticus (FSE) in children can cause acute hippocampal injury and developmental abnormalities. Further research is ongoing to understand the long-term effects of FSE on child development.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Epilepsy Research

Background:

  • Febrile status epilepticus (FSE) is a prolonged seizure episode associated with fever in children.
  • Understanding the neurological consequences of FSE is crucial for early intervention and management.
  • Hippocampal injury and developmental abnormalities are potential outcomes of FSE.

Purpose of the Study:

  • To investigate the acute and long-term effects of FSE on the hippocampus in children.
  • To identify imaging markers associated with FSE in pediatric patients.
  • To compare hippocampal and extrahippocampal abnormalities in children with FSE versus controls.

Main Methods:

  • Prospective enrollment of 199 children (1 month to 5 years) with FSE (>30 minutes) between 2003-2010.
  • Hippocampal-focused MRI in 191 FSE patients, reviewed by blinded neuroradiologists.
  • Comparison with 96 children with simple febrile seizures (FS) using a similar imaging protocol.

Main Results:

  • 11.5% of FSE patients showed abnormal T2 signal in the hippocampus versus 0% in controls (p < 0.0001).
  • Hippocampal developmental abnormalities were more frequent in the FSE group (10.5%) than controls (2.1%) (p = 0.0097).
  • Temporal lobe abnormalities were more common in FSE patients (7.9%) compared to controls (1.0%) (p = 0.015).

Conclusions:

  • FSE poses a risk for acute hippocampal injury in children.
  • A significant proportion of children with FSE exhibit hippocampal developmental abnormalities.
  • Long-term outcome studies are underway to further elucidate the consequences of FSE.
Abstract

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