ACUTE EEG FINDINGS IN CHILDREN WITH FEBRILE STATUS EPILEPTICUS
Abstract number :
B.06
Submission category :
Year :
2005
Submission ID :
22
Source :
www.aesnet.org
Presentation date :
12/3/2005 12:00:00 AM
Published date :
Dec 2, 2005, 06:00 AM
Authors :
1Douglas R. Nordli, 2Solomon L. Moshé, 3L. Matthew Frank, 4John M. Pellock, 5Darrell V. Lewis, 4Anthony Marmarou, 6Dale C. Hesdorffer, 2Shlomo Shinnar, and 1-5
To study the role of acute EEG studies in children with febrile status epilepticus in predicting acute MRI abnormalities and later development of epilepsy and, more specifically, of subsequent mesial temporal sclerosis and temporal lobe epilepsy. As part of the multi-institutional FEBSTAT study, neurological examinations, MRIs with particualr attention to the hippocampus, and EEGs were performed within 72 hours of febrile status epilepticus in children five years of age or younger. EEGs are read by two independent readers, blinded to clinical histories, and a consensus is reached. The primary outcome measure of the ongoing FEBSTAT study is the development of MTS, clinical epilepsy, or both. The study also seeks to determine if initial imaging and EEG studies can predict outcome. As of April, 2005, 75 subjects have been enrolled. Consensus readings have been performed on the first 46 EEGs. Of these, 11 (24%) showed one or more abnormality . Specific findings include the following. Nine EEGs demonstrated slowing or attenuation, which was localized to the temporal lobe in 8 cases (17%). In one circumstance the attenuation involved the entire hemisphere. Two other EEGs showed diffuse slowing only. Spikes were the exclusive abnormality in only two tracings (frontal in one, and posterior temporal in the other). Temporal lobe spikes were seen along with temporal lobe slowing in only two cases. Focal temporal slowing, attenuation, or both is seen in 17 % of children with febrile status epilepticus indicating temporal lobe dysfunction in this group. Focal epileptiform discharges were half as common. Further analysis will determine whether the acute EEG abnormalities correlate with hippocampal T2 signal abnormalities that are being seen in a significant number of children in this cohort. Additionally, the design of the study will allow us to look at the evolution of the EEG in those children at high risk for the development of temporal lobe epilepsy. (Supported by NINDS NS43209: Consequences of Prolonged Febrile Seizures in Childhood.)