Abstract
Objective: The FEBSTAT study is a prospective study that seeks to determine the acute and long-term consequences of febrile status epilepticus (FSE) in childhood. Methods: From 2003 to 2010, 199 children age 1 month to 5 years presenting with FSE (>30 minutes) were enrolled in FEBSTAT within 72 hours of the FSE episode. Of these, 191 had imaging with emphasis on the hippocampus. All MRIs were reviewed by 2 neuroradiologists blinded to clinical details. A group of 96 children with first simple FS who were imaged using a similar protocol served as controls. Results: A total of 22 (11.5%) children had definitely abnormal (n = 17) or equivocal (n = 5) increased T2 signal in the hippocampus following FSE compared with none in the control group (p < 0.0001). Developmental abnormalities of the hippocampus were more common in the FSE group (n = 20, 10.5%) than in controls (n = 2, 2.1%) (p < 0.0097) with hippocampal malrotation being the most common (15 cases and 2 controls). Extrahippocampal imaging abnormalities were present in 15.7% of the FSE group and 15.6% of the controls. However, extrahippocampal imaging abnormalities of the temporal lobe were more common in the FSE group (7.9%) than in controls (1.0%) (p = 0.015). Conclusions: This prospective study demonstrates that children with FSE are at risk for acute hippocampal injury and that a substantial number also have abnormalities in hippocampal development. Follow-up studies are in progress to determine the long-term outcomes in these children.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 871-877 |
| Number of pages | 7 |
| Journal | Neurology |
| Volume | 79 |
| Issue number | 9 |
| DOIs | |
| State | Published - Aug 28 2012 |
Funding
Study funding: Supported by NINDS grant NS43209 (PI S. Shinnar, MD, PhD) and NICHD grant 36867 (PI D.C. Hesdorffer, PhD). S. Shinnar is funded by NIH grants NS 43209, NS 045911, NS 053998, NS 066929, 1U10NS077308, and UL1 RR025759; serves on a DSMB for King Pharmaceuticals; has received personal compensation for serving on Scientific Advisory Boards for Questcor and Sunovion, for consulting for Eisai, Questcor, and Neuronex, and speaker honoraria from Eisai, Questcor, and UCB. He has also given expert testimony in medico-legal cases. J. Bello is funded by NIH grant NS 43209. S. Chan is funded by NIH grant NS 43209. D. Hesdorffer is funded by NIH grants NS043209, NS31146, NS078419, 5U01NS04911, HD042823, CDC grants DP002209, MM1002, AUCD grant RT01, Maternal and Child Health Bureau grant MC00007, and grants from the Epilepsy Study Consortium and Epilepsy Foundation of America. She is a consultant to Mt Sinai Medical Center, New York, and has a received a travel grant award from Glaxo Smith Kline. D. Lewis is funded by NIH grant NS 43209. J. MacFall is funded by NIH grants NS43209, MH077745, and CA096821 and a grant from Duke Coulter Translational Research Fund. J. Pellock is funded by NIH grants NS043209 and NS045911 and a grant from the CDC. He has also received research support from Eisai, Marinus, Lundbeck, Pfizer, Questcor, and UCB. He has received compensation for serving on Scientific Advisory Boards for Eisai, Lundbeck, Questcor, Sepracor, and UCB and as a consultant to Catalyst, Eisai, GlaxoSmithKline, King, KV Pharmaceuticals, Lundbeck, Marinus, Neuropace, Pfizer, Questcor, Sepracor, Sunovion, UCB, Upsher Smith, and Valeant. All grants, research support, consultant fees, and honoraria are paid to Virginia Commonwealth University or the physician practice plan (MCV Physicians). D. Nordli is funded by NIH grant NS 43209. L.M. Frank is funded by NIH grants NS043209 and NS045911 and has received grant support from Schwarz-UCB, Ovation-Lundbeck, Eisai, Supernus, and AVI BioPharma. He serves on the Board of Directors at Chesapeake Bay Academy, a school for special needs children. He holds or has held stock in AVI Biopharma, Oncothyreon, Neurologix, Peregrine, Positiveid, and Nanoviricides. He has received personal compensation for work in medico legal cases. S. Moshé is funded by grants from NIH NS43209, NS20253, NS45911, and from the Heffer Family Foundation. He received a consultant fee from Eisai and a speaker's fee and travel expenses from GSK. W. Gomes reports no disclosures. R.C. Shinnar is funded by NIH grants NS043209 and NS045911. She has received compensation for serving on advisory panels for Questcor Pharmaceuticals, Eisai, and Lundbeck and speaker honoraria from Cyberonics and Questcor. She also serves as an expert consultant for the US Department of Justice and has received compensation for work as an expert on medico-legal cases. S. Sun is funded by NIH research 1R01HD060913, 7R01DK071485, 1U01HL101064, 1UL1RR031990, R01HD038356, 2R01HL040619, and R01NS043209. She also serves as a consultant for Nestle. Go to Neurology.org for full disclosures.
ASJC Scopus subject areas
- Clinical Neurology