Consequences of Prolonged Febrile Seizures in Childhood

儿童时期长期热性惊厥的后果

• 批准号: 6579966
• 负责人: Shlomo Shinnar
• 金额: $ 201.55万
• 依托单位: MONTEFIORE MEDICAL CENTER (BRONX, NY)
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-02-01 至 2008-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6579966
• 关键词: clinical research; cognition disorders; convulsions; electroencephalography; epilepsy; febrile seizure; generalized seizures; hippocampus; human subject; infant human (0-1 year); longitudinal human study; magnetic resonance imaging; middle childhood (6-11); nervous system disorder epidemiology; neuropsychological tests; preschool child (1-5); sclerosis

DESCRIPTION (provided by the applicant): Temporal Lobe Epilepsy (TLE) is often associated with Mesial Temporal Sclerosis (MTS). The relationship between Febrile Seizures (FSs) and MTS remains controversial. Retrospective data suggest that prolonged FSs cause MTS, but epidemiological studies have not found this association. Recent data from MRIs performed immediately after FSs provide preliminary evidence that very prolonged FSs (i.e. febrile Status Epilepticus (SE)) sometimes produce acute hippocampal injury that evolves into MTS. Identification of children at high risk to develop MTS is necessary prior to designing interventions aimed at prevention. This study will examine the consequences of febrile SE, and clarify the relationship between febrile SE, MTS, and subsequent epilepsy and cognitive impairment. Short-term consequences will be examined using a cohort of 200 children with febrile SE, who will be recruited at 5 centers. All children will have MRIs within 72 hours of their SE and at one year, as well as viral studies, psychological testing, EEGs and clinical follow-up. Intermediate term outcomes (5-9 years) will be ascertained using a cohort of 40 children recruited between 1995 and 200, all of whom had MRIs within 72 hours of the episode of febrile SE. They will have a follow-up MRI, EEG and psychological testing >5 years later. Long-term (10-20 years) outcomes will be examined using an established epidemiologic cohort of 163 children with febrile SE, prospectively identified between 1984 and 1996. These children will receive an MRI, EEG and psychological testing >10 years later. In those who develop epilepsy, we will characterize seizure types and epilepsy syndromes, and correlate them with the presence or absence of MTS. The following hypotheses will be tested: 1) Hippocampal T2 signal and/or volume abnormalities will be seen on 30-40% of acute MRIs. The occurrence and severity of these abnormalities will correlate with total seizure duration and seizure lateralization, the presence of pre-existing brain abnormalities and febrile SE in the context of human herpes virus 6 or 7 infection; 2) The severity of acute MRI hippocampal abnormalities will predict subsequent MTS; 3) Children developing TLE will have MRI evidence of MTS.; 4) Subjects with MTS will have impaired memory, whether or not they have epilepsy.

描述（由申请人提供）：颞叶癫痫（TLE）通常与介体性硬化症（MTS）有关。 发热癫痫发作（FSS）和MTS之间的关系仍然存在争议。 回顾性数据表明，长时间的FSS引起MT，但是流行病学研究尚未发现这种关联。 FSS后立即进行的MRI的最新数据提供了初步证据，表明非常长的FSS（即发热状态 - 癫痫持续状态（SE））有时会产生急性海马损伤，从而演变为MTS。 在设计旨在预防的干预措施之前，必须识别出高风险开发MTS的儿童。 这项研究将检查发热SE的后果，并阐明发热SE，MTS和随后的癫痫和认知障碍之间的关系。 短期后果将使用200名有高温SE的儿童组成，他们将在5个中心招募。 所有儿童将在SE的72小时内和一年内拥有MRI，以及病毒研究，心理测试，脑电图和临床随访。 中级成果（5-9岁）将使用1995年至200之间招募的40名儿童的队列确定，所有这些儿童都在Febrile SE发作后的72小时内获得了MRI。 他们将进行后续MRI，脑电图和心理测试> 5年后。 长期（10 - 20年）的结局将使用已建立的163名发热性SE儿童的流行病学队列进行检查，并在1984年至1996年之间被前瞻性确定。这些孩子将接受MRI，EEG和心理测试> 10年后。 在那些发展癫痫的人中，我们将表征癫痫发作类型和癫痫综合征，并将其与MT的存在或不存在相关。 将测试以下假设：1）海马T2信号和/或体积异常将在30-40％的急性MRI上看到。 这些异常的发生和严重程度将与总癫痫发作持续时间和癫痫发作横向化，在人类疱疹病毒6或7感染的背景下存在先前存在的脑异常和发热SE； 2）急性MRI海马异常的严重程度将预测随后的MT； 3）患有TLE的儿童将具有MTS的MRI证据。 4）MTS受试者的记忆力会受损，无论是否患有癫痫。