Febrile status epilepticus and its consequences: Insights from the “Consequences of Febrile Status Epilepticus in Childhood” (FEBSTAT) study

Retrospective analyses and small patient series have suggested that febrile status epilepticus (FSE) is associated with hippocampal injury followed by mesial temporal sclerosis and temporal lobe epilepsy. However, these associations are difficult to verify because of numerous potential confounding factors. The Consequences of Febrile Status Epilepticus in Childhood (FEBSTAT) study was designed as a large, prospective study to provide crucial answers about several aspects of FSE including its origin, semiology, duration, relation to fever and infectious organisms, inflammatory markers, neuroimaging, and electroencephalographic (EEG) correlates. Importantly, the FEBSTAT study examined the consequences of FSE including cognitive outcomes, persistent changes in magnetic resonance imaging (MRI), and risk factors for the development of mesial temporal sclerosis and epilepsy. Overall, 199 children were enrolled, and the study has provided important information about many aspects of childhood FSE, described in close to 20 publications. Several chapters in this book focus on the EEG correlates (Moshe & Nordli), inflammatory changes (Gallentine), and the acute and persistent neuroimaging discoveries (Lewis & Scott). This chapter discusses the novel findings about the semiology and duration of pediatric FSE. It delineates the consequences of FSE in the realms of cognitive outcomes (discussed in detail in the Weiss chapter), and predictors of epileptogenesis. Because of the long latency of temporal lobe epilepsy (TLE) that follows FSE, final estimates of the risk for TLE following FSE may require even longer outcome epochs.