Abstracts

Rationale: In 2012 FEBSTAT established a connection between emergent-EEG results and MRI findings for patients with febrile status epilepticus (FSE). However, the role of non-emergent neuro-imaging for complex febrile seizures (CFS) requires further investigation. Neurologists may consider neuroimaging in patients with CFS in the setting of abnormal EEG findings. Our aim was to examine the non-urgent MRI results in patients with CFS and correlate with EEG results. Methods: We retrospectively reviewed 156 consecutive patients with first CFS evaluated at Boston Children's Hospital ED between 1996 and 2011. We included children aged 6 to 60 months after their first CFS who had both an EEG and a minimum follow-up of 2 years. We excluded children with known severe neurologic disability, central nervous system infection/insult, history of unprovoked seizure at baseline, and the presence of acute electrolyte imbalance at the time of CFS. The presence of a prior simple febrile seizure (SFS) or mild developmental delay (assessed by a neurologist after the CFS) was not exclusionary. Complex febrile seizure was defined as seizure activity occurring with a temperature of ?- 38.4C and included all or some of the following features: focal onset, prolonged duration (?-15 min), or recurrence within 24 hours. MRI abnormalities presenting with involvement of the cortex, deep gray matter, and/or white matter were included. Correlation was assessed with SPSS using Pearson's Chi-Square Test. Results: We reviewed 156 patients (70 female). Median age at CFS onset was 1.5 years (IQR: 0.5?"4.58). Median duration of follow-up was 6.3 years (IQR: 3.8?"10.4). Mild developmental delay was noted in 22 patients (14%). Out of 156 patients, 43 (28%) had an abnormal EEG. MRI was completed in 28 (65%) patients with an abnormal EEG findings and of those, 6 (21%) had abnormal MRI results. This was comparable to the 14 (24%) patients with normal EEG and an abnormal MRI (p = 0.812; graph 1). MRI results did not correlate with developmental delay (p=0.295) or development of epilepsy (p=0.918) during follow-up. Conclusions: MRI abnormalities were uncommon in our cohort of children with CFS and the few abnormalities. Children with abnormal EEG did not have more frequent structural abnormalities on MRI. Funding: None.