Short-term outcomes of children with febrile status epilepticus

Febrile status epilepticus (SE) represents the extreme end of the complex f ebrile seizure spectrum. If there are significant sequelae to febrile seizu res, they should br more common in this group. We have prospectively identi fied 180 children aged 1 month to 10 years who presented with febrile SE ov er a 10-year period in Bronx, New York, and Richmond, Virginia. They were c ompared with 244 children who presented with their first febrile seizure (n ot SE) in a prospective study done in the Bronx. The mean age of the children with febrile SE was 1.92 years, and of the com parison group, 1.85 years. Duration of SE was 30-59 min in 103 (58%), 60-11 9 min in 43 (24%), and greater than or equal to 120 min in 34 (18%). Focal features were present in 64 (35%) of cases. There were no deaths and no cas es of new cognitive or motor handicap. Children with febrile SE were more l ikely to be neurologically abnormal (20% vs. 5%; p < 0.001), to have a hist ory of neonatal seizures (3% vs. 0; p = 0.006) and a family history of epil epsy (11% vs. 5%; p = 0.05) and less likely to have a family history of feb rile seizures (15% vs. 27%; p = 0.01) than were children in the comparison group. The shortterm morbidity and mortality of febrile SE are low. There a re differences in the types of children who have febrile SE compared with t hose who experience briefer febrile seizures. Longterm follow-up of this co hort may provide insight into the relationship of prolonged febrile seizure s and subsequent mesial temporal sclerosis.