Complex partial status epilepticus presenting as fever of unknown origin

Area of Science:

• Neurology
• Epileptology

Background:

• Fever of unknown origin (FUO) presents a diagnostic challenge.
• Epilepsy is a common neurological disorder, but its association with fever is not widely recognized.

Observation:

• A patient presented with recurrent, prolonged fever episodes unresponsive to extensive investigation.
• Observed episodes included loss of responsiveness, blank staring, and repetitive arm movements, suggestive of complex partial seizures.
• Fever was documented concurrently with complex partial seizures in a hospital setting.

Findings:

• Diagnosis of complex partial status epilepticus was established.
• Anticonvulsant medication controlled both the seizures and associated fever.
• Discontinuation of medication led to recurrence of both seizures and fever.
• A retrospective study indicated a higher incidence of fever within 24 hours in epilepsy patients compared to non-epilepsy patients.

Implications:

• Complex partial status epilepticus should be considered in the differential diagnosis of fever of unknown origin.
• Fever can be a presenting manifestation of epilepsy, particularly in cases of status epilepticus.
• This case underscores the importance of considering neurological disorders in unexplained fever presentations.