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Advancing FIRES Treatment: The Potential of Intrathecal Dexamethasone
Carol Park1, Douglas R Nordli1, Mohamed Taha1
1Department of Pediatric Neurology, Comer Children's Hospital University of Chicago Chicago Illinois USA.
Annals of the Child Neurology Society
|August 7, 2026
Summary
Febrile infection-related epilepsy syndrome (FIRES) is a rare epilepsy. Intrathecal dexamethasone (IT-DEX) showed promise in treating a pediatric patient with FIRES, leading to seizure control and recovery.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Neuroimmunology
Background:
- Febrile infection-related epilepsy syndrome (FIRES) is a rare and severe epilepsy characterized by refractory status epilepticus after a febrile illness.
- FIRES presents significant challenges in management due to its refractory nature.
Purpose of the Study:
- To report a case of FIRES successfully treated with intrathecal dexamethasone (IT-DEX).
- To evaluate the efficacy of IT-DEX in a pediatric patient with FIRES who failed other treatments.
Main Methods:
- A 12-year-old girl with FIRES was treated with intrathecal dexamethasone (IT-DEX).
- The patient had previously failed multiple antiseizure and immunomodulatory therapies.
Main Results:
- Intrathecal dexamethasone (IT-DEX) resulted in rapid seizure control.
- Significant neurological recovery was observed despite persistent neuroinflammation.
- The patient showed a remarkable clinical and electrographic response to IT-DEX.
Conclusions:
- Intrathecal dexamethasone (IT-DEX) is a promising intervention for FIRES.
- Further research is needed to understand the mechanisms and long-term efficacy of IT-DEX in FIRES.
