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Epilepsy diagnosis and localization in patients with antecedent childhood febrile convulsions
A Hamati-Haddad1, B Abou-Khalil
1Department of Neurology, Vanderbilt University, Nashville, TN 37212, USA.
Insights
Febrile convulsions (FC) are more common in patients with temporal lobe epilepsy (TLE) than other epilepsy types. This suggests a link between childhood FC and TLE, but not extratemporal epilepsy.
Area of Science:
- Neurology
- Epileptology
- Pediatric Neurology
Background:
- Febrile convulsions (FC) are frequently documented in patients evaluated for epilepsy surgery.
- The association between antecedent FC and the specific localization of epilepsy, particularly temporal lobe epilepsy (TLE), remains unclear.
Purpose of the Study:
- To prospectively investigate the incidence and characteristics of FC in patients presenting to an epilepsy clinic.
- To determine if a history of FC is preferentially associated with temporal lobe epilepsy (TLE) compared to extratemporal epilepsy (ETE) or generalized epilepsy (GE).
Main Methods:
- Prospective data collection via patient questionnaires and interviews regarding FC history.
- Analysis of FC incidence in relation to epilepsy diagnosis: TLE, ETE, and GE.
Main Results:
- 13.2% of 1005 patients reported a history of FC.
- FC were significantly more likely to precede TLE (25.2%) compared to ETE (5.6%) or GE (11.0%).
- Simple FC were more prevalent in GE patients than TLE patients, while prolonged FC duration was common in TLE.
Conclusions:
- A preferential association exists between febrile convulsions and temporal lobe epilepsy foci.
- A weaker association was observed between FC and generalized epilepsy.
- FC do not appear to be a significant risk factor for extratemporal epilepsy.
Purpose:
A history of febrile convulsions (FC) is often obtained in patients presenting for surgical treatment of temporal lobe epilepsy (TLE), but it is not clear that preferential temporal localization of epilepsy is associated with antecedent FC.
Methods:
We prospectively inquired about FC and their characteristics in all patients presenting to an epilepsy clinic through a patient questionnaire and interview. We studied the incidence of antecedent childhood febrile convulsions in relation to epilepsy diagnosis.
Results:
FC were reported by 133 of 1005 study patients (13.2%). TLE was more likely to be preceded by FC (78/310, 25.2%) than extratemporal epilepsy (ETE) (12/216, 5.6%) (p < 0.000001) or generalized epilepsy (GE) (16/146, 11.0%) (p < 0.001). Patients with GE were more likely than patients with TLE to have had simple FC (p < 0.00005). Prolonged duration was the most common FC complex feature in TLE patients.
Conclusions:
We demonstrated a preferential association of FC with temporal lobe foci and a weaker association between FC and GE. FC does not appear to be a clear risk factor for ETE.