Can fever treat epileptic encephalopathies?
OBJECTIVE
To describe resistant epileptic encephalopathies that significantly improved after an acute febrile episode (FE).


METHODS
We reviewed the clinical history of patients with daily pharmacoresistant seizures referred to the Saint-Vincent de Paul Hospital in the last 5 years. Four patients experienced seizure arrest in relation with a febrile episode.


RESULTS
The four patients suffered from epileptic encephalopathy. Three were symptomatic, one cryptogenic. They presented spasms and atypical absences, beginning after the age of 1 year. All seizures stopped at the onset of fever, and significant EEG improvement was observed. The seizure-free period ranged from 2 to 24 months.


CONCLUSIONS
The close link between the occurrence of FE and the disappearance of seizures and EEG improvement, contrasting with the previous pharmacoresistance of this epileptic encephalopathy, supports a non fortuitous association. Several mechanisms could explain this phenomenon, including viral etiology, hyperthermia, inflammatory-immune reaction and ACTH release. Better understanding this phenomenon could open new therapeutic perspectives.
Pintaudi
Maria
M
Department of Child Neuropsychiatry G. Gaslini Hospital, University of Genoa, Italy. mariapintaudi@hotmail.com
Eisermann
Monika M
MM
Ville
Dorothée
D
Plouin
Perrine
P
Dulac
Olivier
O
Kaminska
Anna
A
D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001927:Brain Diseases / Q000150:complications / Q000628:therapy* / Q000821:virology; D004351:Drug Resistance; D004569:Electroencephalography; D020803:Encephalitis, Herpes Simplex / Q000473:pathology / Q000821:virology; D004827:Epilepsy / Q000209:etiology / Q000628:therapy* / Q000821:virology; D005260:Female; D007839:Functional Laterality; D006801:Humans; D006979:Hyperthermia, Induced; D007249:Inflammation / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013035:Spasm / Q000209:etiology; D013702:Temporal Lobe / Q000473:pathology
D000927:Anticonvulsants; D000324:Adrenocorticotropic Hormone