title: MRI abnormalities following febrile status epilepticus in children: the FEBSTAT study.
abstract: OBJECTIVE
  The FEBSTAT study is a prospective study that seeks to determine the acute and long-term consequences of febrile status epilepticus (FSE) in childhood.
  
  
  METHODS
  From 2003 to 2010, 199 children age 1 month to 5 years presenting with FSE (>30 minutes) were enrolled in FEBSTAT within 72 hours of the FSE episode. Of these, 191 had imaging with emphasis on the hippocampus. All MRIs were reviewed by 2 neuroradiologists blinded to clinical details. A group of 96 children with first simple FS who were imaged using a similar protocol served as controls.
  
  
  RESULTS
  A total of 22 (11.5%) children had definitely abnormal (n = 17) or equivocal (n = 5) increased T2 signal in the hippocampus following FSE compared with none in the control group (p < 0.0001). Developmental abnormalities of the hippocampus were more common in the FSE group (n = 20, 10.5%) than in controls (n = 2, 2.1%) (p = 0.0097) with hippocampal malrotation being the most common (15 cases and 2 controls). Extrahippocampal imaging abnormalities were present in 15.7% of the FSE group and 15.6% of the controls. However, extrahippocampal imaging abnormalities of the temporal lobe were more common in the FSE group (7.9%) than in controls (1.0%) (p = 0.015).
  
  
  CONCLUSIONS
  This prospective study demonstrates that children with FSE are at risk for acute hippocampal injury and that a substantial number also have abnormalities in hippocampal development. Follow-up studies are in progress to determine the long-term outcomes in these children.
authors: Neurology and Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. sshinnar@aol.com
authors: Shlomo
authors: S
authors: Shinnar
authors: Jacqueline A
authors: JA
authors: Bello
authors: Stephen
authors: S
authors: Chan
authors: Dale C
authors: DC
authors: Hesdorffer
authors: Darrell V
authors: DV
authors: Lewis
authors: James
authors: J
authors: Macfall
authors: John M
authors: JM
authors: Pellock
authors: Douglas R
authors: DR
authors: Nordli
authors: L Matthew
authors: LM
authors: Frank
authors: Solomon L
authors: SL
authors: Moshe
authors: William
authors: W
authors: Gomes
authors: Ruth C
authors: RC
authors: Shinnar
authors: Shumei
authors: S
authors: Sun
mesh_terms: D001921:Brain / Q000473:pathology; D002675:Child, Preschool; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D015588:Observer Variation; D011446:Prospective Studies; D012307:Risk Factors; D003294:Seizures, Febrile / Q000473:pathology*; D013226:Status Epilepticus / Q000473:pathology*; D013702:Temporal Lobe / Q000473:pathology