Febrile seizures are a syndrome of secondarily generalized hippocampal epilepsy

Abstract

the objective of this study was to examine in detail the semiology of febrile seizures, particularly to look for features that might suggest focality. In prolonged febrile seizures there is acute evidence of hippocampal involvement. Retrospective data relates mesial temporal sclerosis to such early prolonged febrile seizures. Animal models of prolonged seizures causing hippocampal damage show limbic seizures at low dose of the precipitants. a detailed history of the early ictal phase of 10 children with typical febrile seizures and of the behavioural components of 10 children with high fever was taken by two independent observers and a consensus reached. there were seven males and three females aged 1 year to 2y 8mo (mean age 1y 11mo). In seven of the 10 children with febrile seizures there was an early phase of the attack compatible with focal origin and in four of these there were clear mesial temporal features. No such features were seen in the children with fever alone. we conclude that the majority of febrile seizures have evidence of focal origin and many appear to arise in the hippocampus.