Chapter 6 - Do Febrile Seizures Promote Temporal Lobe Epilepsy? Retrospective Studies

Abstract

The sequence of febrile seizures followed by intractable temporal lobe epilepsy is rarely seen from a population perspective. There is a significant relationship between a history of prolonged febrile seizures in early childhood and mesial temporal sclerosis. This association results from complex interactions among several genetic and environmental factors. Early febrile seizure damages the hippocampus, and therefore the child has a prolonged febrile seizure because the hippocampus was previously damaged. A retrospective study of a series of 167 consecutive patients with lesional epilepsy supports the concept of prolonged febrile seizure leading to mesial temporal sclerosis in a predisposed hippocampus. In the study, febrile seizures were recurrent in five patients: three had simple and two had complex febrile seizures. There is a strong correlation between mesial temporal sclerosis and the severity of the epilepsy. Although there is a high incidence of complex febrile seizures among patients with mesial temporal sclerosis, it is still not clear whether complex febrile seizures are an epiphenomenon or a causative factor.