Stephen Chan MD, Presenter: Nothing to Disclose

Hong Tian, Abstract Co-Author: Nothing to Disclose

W. Allen Hauser MD, Abstract Co-Author: Nothing to Disclose

Linda Leary MD, Abstract Co-Author: Nothing to Disclose

Dale C. Hesdorffer PHD, Abstract Co-Author: Nothing to Disclose

Clinical and experimental data suggest that preexisting pathology could have a role in producing febrile seizures that are both focal and prolonged. We studied children with first febrile seizure to determine whether or not MRI-detected brain abnormalities were more common among children with a first complex febrile seizure than among those with a first simple febrile seizure and, if so, what abnormalities predominated.

159 children, aged 6 months to 5 years, with a first febrile seizure, were prospectively identified in the Pediatric Emergency Room at the NY-Presbyterian Hospital. MRI's were done within one week of the first febrile seizure and included high-resolution T2-weighted fast spin-echo and fast inversion recovery pulse sequences. MRI's were read blind to seizure type and neurological examination. Kappa was 0.65 on repeat readings of 68 scans (95% CI=0.47-0.83). Associations are presented only for the most frequently detected abnormalities.

MRI abnormalities occurred in 55 children (34.4%). Total number of abnormalities in these children was 73; more than one abnormality was found in 14 children. The two most common abnormalities were abnormal myelination pattern (N=12; 16.4% of abnormalities) and subcortical white matter hyperintense lesions (N=24; 32.9%). Compared to children with other febrile seizure types, abnormal myelination pattern was associated with focal and prolonged febrile seizures (OR=4.1 (95% CI=1.0-17.5), prolonged febrile seizure (OR=2.6, 95% CI=0.7-9.2), and focal febrile seizures (OR=3.0, 95% CI=0.8-10.9), but not with repeated febrile seizure (OR=1.0, 95% CI=0.2-4.7). Compared to children with other febrile seizure types, subcortical focal hyperintensities was associated with focal and prolonged febrile seizures (OR=3.9 (95% CI=1.1-12.2), prolonged febrile seizure (OR=2.2, 95% CI=0.8-6.1), and focal febrile seizures (OR=2.7, 95% CI=1.0-7.4), but not with repeated febrile seizure (OR=1.3, 95% CI=0.5-4.0).

Children with a first febrile seizure that is focal and prolonged are more likely to have focal subcortical white matter lesions or an abnormal myelination pattern on MRI than children with other kinds of first febrile seizure.

Chan, S, Tian, H, Hauser, W, Leary, L, Hesdorffer, D, Types of MRI-detected Brain Abnormalities in Children with a First Febrile Seizure.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4412879.html