OBJECTIVE: The FEBSTAT (Consequences of Prolonged Febrile Seizures) study is prospectively addressing the relationships among serial EEG, MRI, and clinical follow-up in a cohort of children followed from the time of presentation with febrile status epilepticus (FSE). METHODS: We recruited 199 children with FSE within 72 hours of presentation. Children underwent a detailed history, physical examination, MRI, and EEG within 72 hours. All EEGs were read by 2 teams and then conferenced. Associations with abnormal EEG were determined using logistic regression. Interrater reliability was assessed using the κ statistic. RESULTS: Of the 199 EEGs, 90 (45.2%) were abnormal with the most common abnormality being focal slowing (n = 47) or attenuation (n = 25); these were maximal over the temporal areas in almost all cases. Epileptiform abnormalities were present in 13 EEGs (6.5%). In adjusted analysis, the odds of focal slowing were significantly increased by focal FSE (odds ratio [OR] = 5.08) and hippocampal T2 signal abnormality (OR = 3.50) and significantly decreased with high peak temperature (OR = 0.18). Focal EEG attenuation was also associated with hippocampal T2 signal abnormality (OR = 3.3). CONCLUSIONS: Focal EEG slowing or attenuation are present in EEGs obtained within 72 hours of FSE in a substantial proportion of children and are highly associated with MRI evidence of acute hippocampal injury. These findings may be a sensitive and readily obtainable marker of acute injury associated with FSE.
OBJECTIVE: The FEBSTAT (Consequences of Prolonged Febrile Seizures) study is prospectively addressing the relationships among serial EEG, MRI, and clinical follow-up in a cohort of children followed from the time of presentation with febrile status epilepticus (FSE). METHODS: We recruited 199 children with FSE within 72 hours of presentation. Children underwent a detailed history, physical examination, MRI, and EEG within 72 hours. All EEGs were read by 2 teams and then conferenced. Associations with abnormal EEG were determined using logistic regression. Interrater reliability was assessed using the κ statistic. RESULTS: Of the 199 EEGs, 90 (45.2%) were abnormal with the most common abnormality being focal slowing (n = 47) or attenuation (n = 25); these were maximal over the temporal areas in almost all cases. Epileptiform abnormalities were present in 13 EEGs (6.5%). In adjusted analysis, the odds of focal slowing were significantly increased by focal FSE (odds ratio [OR] = 5.08) and hippocampal T2 signal abnormality (OR = 3.50) and significantly decreased with high peak temperature (OR = 0.18). Focal EEG attenuation was also associated with hippocampal T2 signal abnormality (OR = 3.3). CONCLUSIONS: Focal EEG slowing or attenuation are present in EEGs obtained within 72 hours of FSE in a substantial proportion of children and are highly associated with MRI evidence of acute hippocampal injury. These findings may be a sensitive and readily obtainable marker of acute injury associated with FSE.
Authors: J A French; P D Williamson; V M Thadani; T M Darcey; R H Mattson; S S Spencer; D D Spencer Journal: Ann Neurol Date: 1993-12 Impact factor: 10.422
Authors: S Shinnar; D C Hesdorffer; D R Nordli; J M Pellock; C O'Dell; D V Lewis; L M Frank; S L Moshé; L G Epstein; A Marmarou; E Bagiella Journal: Neurology Date: 2008-06-04 Impact factor: 9.910
Authors: A C McClelland; W A Gomes; S Shinnar; D C Hesdorffer; E Bagiella; D V Lewis; J A Bello; S Chan; J MacFall; M Chen; J M Pellock; D R Nordli; L M Frank; S L Moshé; R C Shinnar; S Sun Journal: AJNR Am J Neuroradiol Date: 2016-09-15 Impact factor: 3.825
Authors: Thomas Bleck; Hannah Cock; James Chamberlain; James Cloyd; Jason Connor; Jordan Elm; Nathan Fountain; Elizabeth Jones; Daniel Lowenstein; Shlomo Shinnar; Robert Silbergleit; David Treiman; Eugen Trinka; Jaideep Kapur Journal: Epilepsia Date: 2013-09 Impact factor: 5.864
Authors: Darrell V Lewis; Shlomo Shinnar; Dale C Hesdorffer; Emilia Bagiella; Jacqueline A Bello; Stephen Chan; Yuan Xu; James MacFall; William A Gomes; Solomon L Moshé; Gary W Mathern; John M Pellock; Douglas R Nordli; L Matthew Frank; James Provenzale; Ruth C Shinnar; Leon G Epstein; David Masur; Claire Litherland; Shumei Sun Journal: Ann Neurol Date: 2014-03-01 Impact factor: 10.422
Authors: Dale C Hesdorffer; Shlomo Shinnar; Daniel N Lax; John M Pellock; Douglas R Nordli; Syndi Seinfeld; William Gallentine; L Matthew Frank; Darrell V Lewis; Ruth C Shinnar; Jacqueline A Bello; Stephen Chan; Leon G Epstein; Solomon L Moshé; Binyi Liu; Shumei Sun Journal: Epilepsia Date: 2016-06-06 Impact factor: 5.864