Febrile Seizures (eBook)

Front Cover 1
Febrile Seizures 4
Copyright Page 5
Contents 6
Contributors 18
Preface 22
Acknowledgments 24
PART I: Epidemiology of Febrile Seizures 26
Chapter 1. The Incidence and Prevalence of Febrile Seizures 26
I. Introduction 26
II. What Is a Febrile Seizure? 27
III. Determining Febrile Seizure Incidence and Prevalence 32
IV. How Common Are Febrile Seizures? 40
V. Why Do We Need Epidemiological Data? 45
References 46
Chapter 2. Antecedents and Risk Factors for Febrile Seizures 52
I. Introduction 52
II. Summary of Key Studies 54
III. Synthesis 59
IV. How Do We Make This Information Useful? 60
References 60
Chapter 3. Recurrent Febrile Seizures 62
I. Introduction 62
II. Risk of a Recurrent Febrile Seizure 63
III. Factors That Predict a First Recurrence 65
IV. Complex Features 71
V. The Role of Treatment in Reducing Risk 72
VI. Summary 73
References 74
PART II: Population Studies on the Outcome of Febrile Seizures 78
Chapter 4. Cognitive Outcome of Febrile Seizures 78
I. Introduction 78
II. Animal Studies 79
III. Human Studies 79
IV. Prolonged or Complex Febrile Seizures 82
V. Behavioral Outcomes 83
VI. Behavioral and Cognitive Side Effects Associated with Antiepileptic Drugs 84
VII. Conclusion 84
References 85
Chapter 5. Febrile Seizures and the Risk for Epilepsy 88
I. Introduction 88
II. Risk for Unprovoked Seizures Following a First Febrile Seizure 90
Ill. Risk Factors for Unprovoked Seizures among Children with Febrile Seizures 91
IV. Febrile Seizures in Cohorts with Epilepsy 97
V. Do Antiepileptic Drugs Prevent Unprovoked Seizures Following Febrile Seizures? 99
VI. Conclusions 99
References 99
Chapter 6. Do Febrile Seizures Promote Temporal Lobe Epilepsy? Retrospective Studies 102
I. Studies 103
II. Conclusions 107
References 108
Chapter 7. Do Febrile Seizures Lead to Temporal Lobe Epilepsy? Prospective and Epidemiological Studies 112
I. Introduction 113
II. Prospective Epidemiological Studies of Febrile Seizures 113
III. Prospective Randomized Therapeutic Trials of Febrile Seizures 114
IV. Prospective Studies of Febrile Status Epilepticus 115
V. Epidemiological Studies of Epilepsy 116
VI. Limitations of Prospective and Population-Based Studies 119
VII. Febrile Seizures and Temporal Lobe Epilepsy: Causal Relationship or Early Marker for Subsequent Temporal Lobe Epilepsy? 121
References 123
PART III: Do Prolonged Febrile Seizures Cause Acute Neuronal Injury? 128
Chapter 8. Do Prolonged Febrile Seizures Injure the Hippocampus? Human MRI Studies 128
I. Introduction 128
II. Retrospective MRI Studies Examining the Link of Complex Febrile Seizures to Hippocampal Injury 130
III. Prospective MRI Studies in Children with Prolonged Seizures 133
IV. MRI Studies and Potential Mechanisms of Hippocampal Injury 138
V. Considerations in MRI Methodology for Detecting Hippocampal Injury Following Complex Febrile Seizures 142
VI. Summary 146
References 146
Chapter 9. Do Prolonged Febrile Seizures Injure Hippocampal Neurons? Insights from Animal Models 152
I. Introduction 153
II. Do Prolonged Experimental Febrile Seizures Cause Acute Hippocampal Cell Death? 154
III. Do Experimental Febrile Seizures Induce Loss of Specific, Vulnerable Populations of Hippocampal Neurons? 155
IV. Do Prolonged "Febrile Seizures" Alter Neurogenesis of the Dentate Gyrus Granule Cells? 157
V. Do Prolonged "Febrile" Seizures Injure Specific Populations of Hippocampal Neurons? 158
VI. Conclusion 159
References 160
Chapter 10. Do Effects of Febrile Seizures Differ in Normal and Abnormal Brain? 164
I. Introduction 164
II. Effects of Febrile Seizures in the Normal Developing Rat 166
III. Effects of Febrile Seizures in the Abnormal Developing Rat 169
References 173
PART IV: The Neurobiology of Febrile Seizures and of Their Consequences: Experimental Approaches 178
Chapter 11. Why Does the Developing Brain Demonstrate Heightened Susceptibility to Febrile and Other Provoked Seizures? 178
I. Introduction 178
II. The Clinical Problem 179
III. Conclusion 187
References 187
Chapter 12. Mechanisms of Fever and Febrile Seizures: Putative Role of the Interleukin-1 System 194
I. Introduction 194
II. The Febrile Response 195
III. IL-1ß in Seizures and Epileptogenesis 203
IV. Human Epileptic Tissue 207
V. Mechanisms of Action and Pharmacological Implications 208
References 209
Chapter 13. Animal Models for Febrile Seizures 214
I. Introduction: Why Use Animal Models to Study Febrile Seizures? 214
II. Characteristics of the Optimal Animal Model for Febrile Seizures 215
III. Published Models of Febrile Seizures 220
IV. Animal Models: Strengths, Limitations, and Uses 222
References 223
Chapter 14. Physiology of Limbic Hyperexcitability after Experimental Complex Febrile Seizures: Interactions of Seizure-Induced Alterations at Multiple Levels of Neuronal Organization 228
I. Introduction 228
II. Limbic Excitability after Experimental Complex Febrile Seizures 229
III. Conclusions and Outlook 235
References 237
Chapter 15. Do Prolonged Febrile Seizures in an Immature Rat Model Cause Epilepsy? 240
I. Do Human Data Support the Notion That Prolonged Febrile Seizures Cause Epilepsy? 241
II. Use of Experimental Complex Febrile Seizures to Address Their Relationship to Epileptogenesis 242
III. Consequences of Prolonged Experimental Febrile Seizures 243
IV. Consequences of Experimental Prolonged Febrile Seizures in This Model 247
V. Functional Consequences of Febrile Seizures 250
VI. Mechanisms for the Enhanced Excitability after Prolonged Experimental Febrile Seizures 251
VII. Summary 252
References 252
Chapter 16. Basic Electrophysiology of Febrile Seizures 256
I. Introduction 257
II. Neuronal Processes Sensitive to Temperature 258
III. Whole-Animal Studies of Hyperthermia 267
IV. Conclusion 268
References 269
PART V: Genetics of Febrile Seizures 274
Chapter 17. The Genetics of Febrile Seizures 274
I. Introduction 274
II. Population, Family, and Twin Studies of Febrile Seizures 275
III. Genetic Analysis Methods 279
IV. Known Linkages for Febrile Seizures 283
V. Summary 286
References 287
PART VI: Current Management of Febrile Seizures 290
Chapter 18. Evaluation of the Child with Febrile Seizures 290
I. Introduction 291
II. Diagnostic Evaluation 291
III. Should the Child with a Febrile Seizure Have a Lumbar Puncture? 293
IV. Electroencephalography in the Management of Febrile Seizures 295
References 296
Chapter 19. Practical Management Approaches to Simple and Complex Febrile Seizures 298
I. Introduction 299
II. Continuous Prophylaxis 301
III. Intermittent Prophylaxis 304
IV. Immediate Anticonvulsant Therapy 312
V. Antipyretic Treatment 316
VI. Deciding Who and How to Treat 317
VII. Supportive Family Management 321
References 321
Chapter 20. What Do We Tell Parents of a Child with Simple or Complex Febrile Seizures? 330
I. Introduction 330
II. Information 331
III. Learning Theories 338
IV. Conclusions 338
V. Available Resources 339
References 340
PART VII: Current State of the Art: Implications for Future Study and Treatment 342
Chapter 21. Human Data: What Do We Know about Febrile Seizures and What Further Information Is Needed 342
I. Genetics 342
II. Role of Magnetic Resonance Imaging and Functional Imaging in Defining Seizure-Induced Hippocampal Injury 343
III. Role of Preexisting Abnormalities in Seizure-Induced Injury 344
IV. Fever versus Hyperthermia 344
V. Role of Specific Pathogens 345
VI. Epilepsy Syndromes 345
VII. The Controversial Relationship between Prolonged Febrile Seizures, Mesial Temporal Sclerosis, and Temporal Lobe Epilepsy 346
VIII. Cognitive and Behavioral Outcomes and Memory 346
IX. Treatment and Neuroprotection 347
X. Summary 348
References 348
Chapter 22. Mechanisms and Outcome of Febrile Seizures: What Have We Learned from Basic Science Approaches, and What Needs Studying? 350
I. What Are the Key Questions? 350
II. What Have We Learned So Far? 352
III. What Are the Goals for Experimental Approaches to Febrile Seizures? 352
References 353
Index 354