Febrile Status Epilepticus

Abstract

Febrile status epilepticus (FSE) is defined as a febrile seizure lasting 30 minutes or more and is considered the extreme end of the complex febrile seizure spectrum. It remains unclear why some children are predisposed to the development of FSE compared with others. FSE is considered as medical emergency and as such, early treatment is crucial. The consequences of FSE have been a topic of interest for many years, specially its association with temporal lobe epilepsy and hippocampal sclerosis. In this article, we review the epidemiology, risk factors, pathophysiology, treatment, and prognosis including findings from the “Consequences of Prolonged Febrile Seizures in Childhood” (FEBSTAT) study.

Keywords

seizures - epilepsy - febrile seizures - febrile status epilepticus

• References

• 1 Shinnar S, Pellock JM, Moshé SL. , et al. In whom does status epilepticus occur: age-related differences in children. Epilepsia 1997; 38 (08) 907-914
• 2 Chan S, Bello JA, Shinnar S. , et al; FEBSTAT Study Team. Hippocampal malrotation is associated with prolonged febrile seizures: results of the FEBSTAT study. AJR Am J Roentgenol 2015; 205 (05) 1068-1074
• 3 Lewis DV, Shinnar S, Hesdorffer DC. , et al; FEBSTAT Study Team. Hippocampal sclerosis after febrile status epilepticus: the FEBSTAT study. Ann Neurol 2014; 75 (02) 178-185
• 4 Baram TZ, Shinnar S. , eds. Febrile Seizures. San Diego, CA: Academic Press; 2002: 215-229
• 5 Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med 1987; 316 (09) 493-498
• 6 Berg AT, Shinnar S. Unprovoked seizures in children with febrile seizures: short-term outcome. Neurology 1996; 47 (02) 562-568
• 7 Seinfeld SSS. Febrile Seizures. In: Swaiman's Pediatric Neurology: Principles and Practice. 6th edition. Edinburgh: Elsevier Saunders; 2017: 519-523
• 8 Hesdorffer DC, Shinnar S, Lewis DV. , et al; Consequences of Prolonged Febrile Seizures in Childhood (FEBSTAT) Study Team. Risk factors for febrile status epilepticus: a case-control study. J Pediatr 2013; 163 (04) 1147-51.e1
• 9 Hesdorffer DC, Shinnar S, Lax DN. , et al; FEBSTAT study team. Risk factors for subsequent febrile seizures in the FEBSTAT study. Epilepsia 2016; 57 (07) 1042-1047
• 10 Trinka E, Cock H, Hesdorffer D. , et al. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia 2015; 56 (10) 1515-1523
• 11 Stanhope JM, Brody JA, Brink E, Morris CE. Convulsions among the Chamorro people of Guam, Mariana islands. II. Febrile convulsions. Am J Epidemiol 1972; 95 (03) 299-304
• 12 Berg AT, Shinnar S. Complex febrile seizures. Epilepsia 1996; 37 (02) 126-133
• 13 Hesdorffer DC, Shinnar S, Lewis DV. , et al; FEBSTAT study team. Design and phenomenology of the FEBSTAT study. Epilepsia 2012; 53 (09) 1471-1480
• 14 Shinnar S, Bello JA, Chan S. , et al; FEBSTAT Study Team. MRI abnormalities following febrile status epilepticus in children: the FEBSTAT study. Neurology 2012; 79 (09) 871-877
• 15 Epstein LG, Shinnar S, Hesdorffer DC. , et al; FEBSTAT study team. Human herpesvirus 6 and 7 in febrile status epilepticus: the FEBSTAT study. Epilepsia 2012; 53 (09) 1481-1488
• 16 Gallentine WB, Shinnar S, Hesdorffer DC. , et al; FEBSTAT Investigator Team. Plasma cytokines associated with febrile status epilepticus in children: a potential biomarker for acute hippocampal injury. Epilepsia 2017; 58 (06) 1102-1111
• 17 Dubé C, Vezzani A, Behrens M, Bartfai T, Baram TZ. Interleukin-1beta contributes to the generation of experimental febrile seizures. Ann Neurol 2005; 57 (01) 152-155
• 18 Patterson KP, Brennan GP, Curran M. , et al. Rapid, coordinate inflammatory responses after experimental febrile status epilepticus: implications for epileptogenesis. eNeuro 2015; 2 (05) ENEURO.0034-15.2015
• 19 Seinfeld S, Shinnar S, Sun S. , et al; FEBSTAT study team. Emergency management of febrile status epilepticus: results of the FEBSTAT study. Epilepsia 2014; 55 (03) 388-395
• 20 Bassan H, Barzilay M, Shinnar S, Shorer Z, Matoth I, Gross-Tsur V. Prolonged febrile seizures, clinical characteristics, and acute management. Epilepsia 2013; 54 (06) 1092-1098
• 21 Alldredge BK, Gelb AM, Isaacs SM. , et al. A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med 2001; 345 (09) 631-637
• 22 Glauser T, Shinnar S, Gloss D. , et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr 2016; 16 (01) 48-61
• 23 Shinnar S, Berg AT. Does antiepileptic drug therapy prevent the development of “chronic” epilepsy?. Epilepsia 1996; 37 (08) 701-708
• 24 Shinnar S, Pellock JM, Berg AT. , et al. Short-term outcomes of children with febrile status epilepticus. Epilepsia 2001; 42 (01) 47-53
• 25 Nordli Jr DR, Moshé SL, Shinnar S. , et al; FEBSTAT Study Team. Acute EEG findings in children with febrile status epilepticus: results of the FEBSTAT study. Neurology 2012; 79 (22) 2180-2186
• 26 Weiss EF, Masur D, Shinnar S. , et al; FEBSTAT study team. Cognitive functioning one month and one year following febrile status epilepticus. Epilepsy Behav 2016; 64 (Pt A): 283-288
• 27 Hesdorffer DC, Benn EK, Bagiella E. , et al; FEBSTAT Study Team. Distribution of febrile seizure duration and associations with development. Ann Neurol 2011; 70 (01) 93-100
• 28 Shinnar RC, Shinnar S, Hesdorffer DC. , et al; FEBSTAT Study Team. Parental stress, pediatric quality of life, and behavior at baseline and one-year follow-up: results from the FEBSTAT study. Epilepsy Behav 2017; 69: 95-99