Abstracts

Febrile status epilepticus (FSE) may be associated with the development of mesial temporal sclerosis and intractable temporal lobe epilepsy. If ongoing prospective studies support this, then prevention of FSE becomes a central concern. We, therefore, undertook an analysis to identify risk factors for FSE., This analysis combines data from two prospective studies, employing almost identical protocols and questionnaires: children with incident FSE (N=73) from the FEBSTAT study; and children with incident simple (N=105) and complex (N=46) febrile seizures (FS) that were not FSE from the Columbia University Febrile Seizure study. At identification, parents were questioned about potential FS antecedents and an MRI was performed within 72 hours. Within one month of the FS, children received a neurological examination and developmental testing. Logistic regression was used to evaluate potential FSE risk factors, comparing FSE to simple FS and complex FS (not FSE) to simple FS., Compared to children with simple FS, children with febrile SE were less likely to be 18 months and older (OR=0.5; 95% CI=0.2-0.8) and less likely to have fevers of 104.0 or more (OR=0.2; 95% CI=0.1-0.5). Similar non-significant results were seen for other complex FS vs. simple FS. Smoking during pregnancy was strongly associated with FSE compared to simple FS (OR=3.6, 95% CI=1.4-9.4) as was drinking during pregnancy (OR=9.6, 95% CI=1.1-82.3). Smoking was also associated with a 2.1-fold non-significant increased risk complex FS compared to simple FS. No associations were observed for family history of febrile seizure, neurological abnormality, or day care attendance., Risk factors appear to be different for both FSE and other complex FS compared to simple FS. The reason for the robust association between smoking during pregnancy and FSE deserves further study., (Supported by R01 HD 36867 and R01 NS043209.)