Abstract
Epidemiological studies do not support a causal association between febrile seizures and epilepsy in general and temporal lobe epilepsy in particular. Febrile seizures, particularly complex febrile seizures, are associated with an increased risk of epilepsy, though not necessarily of temporal lobe epilepsy. Although there is strong evidence supporting the occurrence of seizure-induced injury, epidemiological data do not support an association between less prolonged seizures—even if complex—and temporal lobe epilepsy. Retrospective studies from tertiary epilepsy centers report that many adults with intractable temporal lobe epilepsy have a history of prolonged febrile seizures in childhood. This chapter reviews data from epidemiological and prospective studies of febrile seizures and epilepsy regarding the association between febrile seizures, particularly prolonged febrile seizures, and subsequent temporal lobe epilepsy. The risk of developing epilepsy after a single simple febrile seizure is only mildly elevated over the risk in the general population. If febrile seizures are causally related to epilepsy, then preventing them should reduce the risk of subsequent epilepsy. The studies report a much higher risk of epilepsy following febrile status epilepticus.
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