Phenomenology of prolonged febrile seizures: results of the FEBSTAT study.


Journal Article

BACKGROUND: Febrile status epilepticus (FSE) has been associated with hippocampal injury and subsequent mesial temporal sclerosis and temporal lobe epilepsy. However, little is known about the semiology of FSE. METHODS: A prospective, multicenter study of the consequences of FSE included children, aged 1 month through 5 years, presenting with a febrile seizure lasting 30 minutes or more. Procedures included neurologic history and examination and an MRI and EEG within 72 hours. All information related to seizure semiology was reviewed by three epileptologists blinded to MRI and EEG results and to subsequent outcome. Inter-rater reliability was assessed by the kappa statistic. RESULTS: Among 119 children, the median age was 1.3 years, the mean peak temperature was 103.2 degrees F, and seizures lasted a median of 68.0 minutes. Seizure duration followed a Weibull distribution with a shape parameter of 1.68. Seizures were continuous in 52% and behaviorally intermittent (without recovery in between) in 48%; most were partial (67%) and almost all (99%) were convulsive. In one third of cases, FSE was unrecognized in the emergency department. Of the 119 children, 86% had normal development, 24% had prior febrile seizures, and family history of febrile seizures in a first-degree relative was present in 25%. CONCLUSIONS: Febrile status epilepticus is usually focal and often not well recognized. It occurs in very young children and is usually the first febrile seizure. Seizures are typically very prolonged and the distribution of seizure durations suggests that the longer a seizure continues, the less likely it is to spontaneously stop.

Full Text

Duke Authors

Cited Authors

  • Shinnar, S; Hesdorffer, DC; Nordli, DR; Pellock, JM; O'Dell, C; Lewis, DV; Frank, LM; Moshé, SL; Epstein, LG; Marmarou, A; Bagiella, E; FEBSTAT Study Team,

Published Date

  • July 15, 2008

Published In

Volume / Issue

  • 71 / 3

Start / End Page

  • 170 - 176

PubMed ID

  • 18525033

Pubmed Central ID

  • 18525033

Electronic International Standard Serial Number (EISSN)

  • 1526-632X

Digital Object Identifier (DOI)

  • 10.1212/01.wnl.0000310774.01185.97


  • eng

Conference Location

  • United States