Abstracts

RATIONALE: The evaluation, management and prognosis of children with complex febrile seizures (CFS) remain controversial. Although benign in the majority of cases, few patients with febrile seizures are known to present with recurrent, focal and occassionally prolonged episodes. The usefulness of EEG and neuroimaging in these cases is not well established. METHODS: We reviewed the medical records of children seen by the pediatric neurology consult team from January 1999-April 2000 for evaluation of febrile seizures. Patients who met the criteria for complex febrile seizures were included in the analysis. The results of EEG and neuroimaging studies in these patients were reviewed. RESULTS: There were 27 patients seen for evaluation of febrile seizures by the neurology consult team during this period. Age ranged from 8 months to 4.5 years old (average of 22 months). There were 16 females and 11 males. Eighteen patients (67%) had complex febrile seizures, of these, 10 (55%) presented in status epilepticus. Twelve (67%) of the eighteen patients with complex febrile seizures had cranial computerized tomography (CT). Only one patient had an abnormal study showing a right parietal tumor. Of the eighteen patients with CFS, six underwent brain magnetic resonance imaging (MRI). Of these 6 patients, 4 had abnormalities. Two patients had left mesial temporal sclerosis, both patients were among the ones that presented with status epilepticus. One patient had a complete agenesis of corpus callosum and the fourth patient had a right parietal tumor which was identified by the CT imaging. All patients with CFS had an EEG, only 2 patients had an abnormal study. One showed right posterior quadrant spikes and the other showed left posterior quadrant slowing. CONCLUSIONS: In patients with complex febrile sizures, brain MRI can be useful in identifying patients who may go on to develop epilepsy, whereas CT scan yield remains low when studying these patients. EEG although widely used had a low yield for abnormalities.