Related Experiment Video

Updated: Oct 27, 2025

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
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Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

Published on: December 6, 2016

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Report of a Child With Febrile Status Epilepticus and Post-COVID Multi-System Inflammatory Syndrome

Holly C Appleberry1, Alexis Begezda2, Helen Cheung3

  • 1Department of Neurology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.

Child Neurology Open
|July 21, 2021
PubMed

Insights

Multi-system Inflammatory Syndrome in Children (MIS-C) can trigger Febrile Infection Related Epilepsy Syndrome (FIRES) in infants. Early recognition of MIS-C is crucial for managing this rare neurological complication post-COVID.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroimmunology

Background:

  • Multi-system Inflammatory Syndrome in Children (MIS-C) is a rare post-infectious complication following COVID-19.
  • Central nervous system (CNS) involvement in MIS-C is uncommon and presents with diverse clinical and imaging findings.
  • Febrile Infection Related Epilepsy Syndrome (FIRES) is a distinct clinical entity characterized by refractory status epilepticus.

Observation:

  • A case of an infant presenting with refractory febrile status epilepticus is described.
  • The infant later met clinical criteria for MIS-C, with significant multi-organ involvement.
  • Brain MRI revealed diffuse restricted diffusion, predominantly in anterior regions.

Findings:

  • The patient exhibited a heterogeneous presentation suggestive of CNS involvement in MIS-C.
  • Genetic testing revealed multiple variants of uncertain significance.
  • Treatment with pulse steroids and intravenous immunoglobulin (IVIg) led to clinical improvement.

Implications:

  • This case underscores the importance of considering MIS-C in the differential diagnosis of FIRES, especially after COVID-19 exposure.
  • Early identification and management of MIS-C can be critical for neurological outcomes in affected children.
  • Further research is needed to elucidate the pathophysiology linking COVID-19, MIS-C, and FIRES.

Keywords:
COVIDabnormal brain MRIfebrile infection related epilepsy syndrome (FIRES)multi-system inflammatory syndrome in childrenstatus epileptics

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