Abstracts

Prolonged, febrile seizures, particularly focal ones have been associated with subsequent temporal lobe epilepsy. Most data on these prolonged seizures comes from retrospective studies. We present the preliminary findings from the FEBSTAT study., FEBSTAT is a prospective multicenter study of febrile status epilepticus (FSE) ([ge]30 min) designed to determine whether prolonged febrile seizures cause acute hippocampal damage and if so, does it lead to mesial temporal sclerosis? As part of the study eligible subjects have a detailed interview and neurological examination within 72 hours. All records are then reviewed by 3 central reviewers (SS, DRN and JMP) and consensus is reached regarding seizure duration, intermittent or continuous and focality among other features., As of May 1, 107 children with FSE have been enrolled with a mean age if 21 months. Prior febrile seizures (FS) occurred in 22% and normal development was present in 88%. The mean peak temperature was 103.1F. We have finished doing central scoring and interrater reliability on the first 58 cases. Mean seizure duration was 79 mins (though usually underestimated by non-study clinicians). Of these 52% were continuous, 33% intermittent without recovery imbetween and 16% initially stopped with medication and then resumed without recovery.
The seizures were considerd focal in 59% (definitely in 39% and probably in 20%) and generalized in 41% (definitely generalized in 30% and possibly focal in 10%). Definite lateralization could be assigned on clinical semiological grounds in 36%. There was good to excellent interrater reliability in classification. Reliability was particularly high on whether the seizure was continous or intermittent and lowest on whether focal features were present., Prolonged febrile seizures are often very prolonged and their duration is underrecognized. The majority of prolonged FS are focal. Intermittent forms of FSE are much more common than previously thought. Correlation of clinical phenomenology and imaging and EEG findings as well as with longer term outcomes are currently in progress., (Supported by: Funded by grant NS 43209 [ldquo]Consequences of Prolonged Febrile Seizures in Childhood[quot] from NINDS)