New research shows that children with febrile status epilepticus (FSE) who receive earlier treatment with antiepileptic drugs (AEDs) experience a reduction in the duration of the seizure. The study published in Epilepsia, a journal of the International League Against Epilepsy (ILAE), suggests that a standard Emergency Medical Services (EMS) treatment protocol for FSE is needed in the U.S.
While medical evidence reports that brief or simple febrile seizures are most common, up to 10% of cases are prolonged and meet the criteria for status epilepticus (SE)—a critical condition where a persistent seizure lasts more than 30 minutes. Prior research shows that FSE accounts for 25% of all childhood SE, with more than 70% of SE cases occurring in the second year of life. Prolonged seizures place patients at risk of short-term and long-term complications, including the development of epilepsy.
"The time from the start of the seizure to treatment is crucial to improving patient outcomes," said lead author Syndi Seinfeld, DO, assistant professor, Division of Child Neurology at Children's Hospital of Richmond at Virginia Commonwealth University. "Our study is the first to examine the treatment of FSE by EMS, which currently does not have a standard therapy protocol for prolonged seizures."
The present study recruited 199 pediatric patients who were part of the FEBSTAT study—a prospective, multicenter, NIH-funded study (PI Shlomo Shinnar MD PhD at Albert Einstein College of Medicine) investigating the consequences of FSE. The children, between the ages of 1 month and 6 years, had a seizure or cluster of seizures lasting more than 30 minutes. Researchers analyzed the relationship between seizure duration, treatment delay and related morbidity.
"The FEBSTAT study is designed to understand the consequences of prolonged febrile seizures in hopes of identifying children at greater risk of adverse outcomes and to help develop better treatments," said Brandy Fureman, Ph.D., a program director at the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health.
Findings indicate that roughly 90% (179) of children received at least one AED and more than AED was needed in 70% (140) of patients to terminate FSE. On average it was 30 minutes from the seizure onset to the time EMS or emergency department staff administered the first AED. The mean seizure time was 81 minutes for children treated prior to arrival at the emergency department and 95 minutes for those who were not.
Further analyses determined the average time to end the seizure was 38 minutes following the first AED dose. Seizure duration was 83 minutes in 48% of patients who needed respiratory support and 58 minutes for subjects not requiring respiratory support.
"Our findings clearly show that early AED initiation results in shorter seizure duration," concludes Dr. Seinfeld. "A standard FSE treatment protocol prior to arrival at the hospital, along with training for EMS staff, is needed across the U.S. to help improve outcomes for children with prolonged seizures."
This study is published in Epilepsia. Media wishing to receive a PDF of this article may contact firstname.lastname@example.org.
Full citation: "Emergency Management of Febrile Status Epilepticus: Results of The FEBSTAT Study." Syndi Seinfeld, Shlomo Shinnar, Shumei Sun, Dale C Hesdorffer, Xiaoyan Deng, Ruth C Shinnar, Kathryn O'Hara, Douglas R Nordli Jr, L Matthew Frank, William Gallentine, Solomon L Moshé, John M Pellock and the FEBSTAT study team. Epilepsia; Published Online: February 6, 2014 (DOI: 10.1111/epi.12526).
URL Upon Publication: http://doi.wiley.com/10.1111/epi.12526
Author Contact: Media wishing to speak with Dr. Seinfeld may contact Eric Peters with Virginia Commonwealth University at email@example.com or at 804-828-0563.
About the Journal
Epilepsia is the leading, most authoritative source for current clinical and research results on all aspects of epilepsy. As the journal of the International League Against Epilepsy, subscribers every month will review scientific evidence and clinical methodology in: clinical neurology, neurophysiology, molecular biology, neuroimaging, neurochemistry, neurosurgery, pharmacology, neuroepidemiology, and therapeutic trials. For more information, please visit http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1528-1167.
About the International League Against Epilepsy
The International League Against Epilepsy (ILAE) is the world's preeminent association of physicians and health professionals working toward a world where no person's life is limited by epilepsy. Since 1909 the ILAE has provided educational and research resources that are essential in understanding, diagnosing and treating persons with epilepsy. The ILAE supports health professionals, patients, and their care providers, governments, and the general public worldwide by advancing knowledge of epilepsy.
Wiley is a global provider of content-enabled solutions that improve outcomes in research, education, and professional practice. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners.
Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia.
Dawn Peters | EurekAlert!
Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)
The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft
University of Maryland researchers contribute to historic detection of gravitational waves and light created by event
On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...
Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.
Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....
Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).
When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...
Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.
How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...
Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.
It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...
17.10.2017 | Event News
10.10.2017 | Event News
10.10.2017 | Event News
20.10.2017 | Information Technology
20.10.2017 | Materials Sciences
20.10.2017 | Interdisciplinary Research