1. MRI abnormalities following febrile status epilepticus in children: the FEBSTAT study
- Author
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Shinnar, Shlomo, Bello, Jacqueline A, Chan, Stephen, Hesdorffer, Dale C, Lewis, Darrell V, Macfall, James, Pellock, John M, Nordli, Douglas R, Frank, L Matthew, Moshe, Solomon L, Gomes, William, Shinnar, Ruth C, Sun, Shumei, and FEBSTAT Study Team
- Subjects
Male ,Image Processing ,Clinical Sciences ,FEBSTAT Study Team ,Hippocampus ,Febrile ,Cohort Studies ,Status Epilepticus ,Computer-Assisted ,Seizures ,Risk Factors ,Clinical Research ,Humans ,2.1 Biological and endogenous factors ,Prospective Studies ,Aetiology ,Child ,Preschool ,Observer Variation ,Neurologic Examination ,Pediatric ,screening and diagnosis ,Epilepsy ,Neurology & Neurosurgery ,Neurosciences ,Brain ,Infant ,Electroencephalography ,Magnetic Resonance Imaging ,Temporal Lobe ,Detection ,Diffusion Magnetic Resonance Imaging ,Biomedical Imaging ,Female ,Cognitive Sciences ,4.2 Evaluation of markers and technologies - Abstract
ObjectiveThe FEBSTAT study is a prospective study that seeks to determine the acute and long-term consequences of febrile status epilepticus (FSE) in childhood.MethodsFrom 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.ResultsA 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).ConclusionsThis 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.
- Published
- 2012