Consequences of Prolonged Febrile Seizures in Childhood

In a National Insitutes of Health-funded, multi-center clinical study, the epilepsy center is studying one of epilepsy's many causes. Neurologists have long debated whether prolonged febrile seizures lead to epilepsy. Febrile, or fever, seizures are common among children under five years old. They occur in approximately 100,000 U.S. children annually when body temperatures rapidly rise above 101°F. Studies on animals have shown an association between a rapid rise in body temperature and seizure activity. In most children, these seizures have no lasting consequences. The study focuses on the 3% of children who have a febrile seizure lasting more than 30 minutes and develop scar tissue in the brain.

Previous studies have attempted to find a link between febrile seizures and epilepsy, but have lacked the funding, methodology and patient population large enough to answer the question. With five medical centers participating in the current study, investigators hope to enroll 200 children. NIH has agreed to continue to support the study for an additional five years.

This is a landmark study that will show if this population develops epilepsy as a result of scarring, and if so, what the risk factors are. The study’s principal investigator is Shlomo Shinnar, MD, at Einstein Medical School in New York City.

In addition to collecting traditional data such as a medical history, magnetic resonance images (MRIs) and EEG analysis, two new vital pieces of information will be gathered from each of the patients — evidence of previous viral infection and genetic markers. Leon G. Epstein, MD, head of Lurie Children’s Division of Neurology, is leading the viral component of the study.

Neuropsychological testing is also done as part of the study to primarily measure global development. At the five-year evaluation, which will precede the development of epilepsy in some cases, more detailed cognitive testing will be performed. Parents also complete questionnaires on the behavior and development of the children.

The goal of the study is to determine who is at risk by recognizing if it is this particular set of clinical characteristics, infection with this virus or this genetic pre-disposition. The aim is to then to investigate "neuroprotective strategies" that might prevent the development of epilepsy in patients identified as high risk.