Chapter

Fever, Febrile Seizures, and Epileptogenesis

Céline M. Dubé, Shawn McClelland, ManKin Choy, Amy L. Brewster, Yoav Noam and Tallie Z. Baram

in Jasper's Basic Mechanisms of the Epilepsies

Fourth edition

Published on behalf of ©Jeffrey L. Noebels, Massimo Avoli, Michael A. Rogawski, Richard W. Olsen, and Antonio V. Delgado-Escueta

Published in print July 2012 | ISBN: 9780199746545
Published online April 2013 | e-ISBN: 9780199322817 | DOI: http://dx.doi.org/10.1093/med/9780199746545.003.0026

Series: Contemporary Neurology Series

Fever, Febrile Seizures, and Epileptogenesis

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Febrile seizures (FS) are the most common type of convulsions in infants and young children, occurring in 2%–6% of children.1,2 They are defined as seizures arising during fever, not caused by an infection of the central nervous system. However, their definition does not exclude children with preexisting neurological deficits, a fact that might confound studies on the outcome of these seizures. Although there is limited evidence for adverse outcomes of simple (defined as short, with no focal motor phenomena) FS on the immature brain, complex FS, particularly long-duration FS or febrile status epilepticus (defined as seizures lasting for more than 30 min), have been associated with subsequent limbic epilepsy, as indicated by both prospective and retrospective studies as well as by recent data in animal models.3–14 Some investigators have suspected that long-duration FS might result in cognitive defects in a subset of children.15–17 Understanding the basic mechanisms of FS, and the potential epileptogenesis that follows them, requires animal models that enable direct examination of the causal mechanisms for the generation and consequences of these seizures. The mechanisms by which fever leads to FS, the outcome of FS measured as the risk of epilepsy, the properties of FS associated with limbic epilepsy, and the mechanisms of epileptogenesis are discussed in the following sections.

Chapter.  6021 words.  Illustrated.

Subjects: Neurology

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