acyclovir and Seizures--Febrile

Topics: Acyclovir; Antiviral Agents; Electroencephalography; Encephalitis, Herpes Simplex; Female; Humans; Infant; Magnetic Resonance Imaging; Meningitis, Bacterial; Neuroimaging; Practice Guidelines as Topic; Seizures, Febrile; Spinal Puncture

To analyze the electroclinical features, neuroimaging findings, treatment, and outcome of 12 patients with febrile infection-related epilepsy syndrome (FIRES).. This is a retrospective study of 12 children with FIRES with a mean time of follow-up of 6.5 years carried out at the Garrahan Hospital of Buenos Aires between 1997 and 2012.. Eight males and four females had focal status epilepticus preceded by febrile infection with a mean age at presentation of 8.5 years. In the acute period, the treatment included antiepileptic drugs (AEDs) in all cases, immunotherapy in 10 cases, and burst-suppression coma in eight. The ketogenic diet was tried in two, plasmapheresis in one, and rituximab in one. Two patients treated with IVIG and one patient given steroids had a good response, but in this phase only three patients had a prolonged good response to IVIG and a ketogenic diet. No patients died in this period. In the chronic epilepsy phase, all children had seizures arising from neocortical regions. All patients had refractory epilepsy, and most mental retardation, and behavioral disturbances. All received different AEDs and in this phase a third patient was put on a ketogenic diet. One patient was operated without good results. Only two cases had a good outcome after 2 and 10 years of follow-up.. FIRES is a well-defined severe epileptic syndrome, probably in the group of epileptic encephalopathies, characterized by focal or multifocal seizures arising from the neocortical regions with an unknown etiology. Immunoglobulin and the ketogenic diet may be considered a potentially efficacious treatment.

Topics: Acyclovir; Adolescent; Antiviral Agents; Argentina; Child; Child, Preschool; Electroencephalography; Encephalitis, Viral; Female; Follow-Up Studies; Humans; Immunoglobulins, Intravenous; Leukocytosis; Magnetic Resonance Imaging; Male; Retrospective Studies; Seizures, Febrile; Status Epilepticus; Syndrome; Treatment Outcome; Unconsciousness

We describe a rare case of Influenza B-associated encephalopathy with hemorrhagic lesions of the corpus callosum. A 12-year-old Caucasian girl presented a 24-h fever followed by partial seizure, secondarily generalized, and disturbance of consciousness. Magnetic resonance imaging on Day 2 of her illness showed two hemorrhagic lesions of the corpus callosum. The Influenza B virus was found on nasopharyngeal swab. Neurologic signs had completely recovered by Day 3. A review of the literature identified a few similar cases; the common features include a relatively older age and prompt and complete recovery from clinical symptoms. This is the first report to describe hemorrhagic lesions of the corpus callosum in influenza.

Topics: Acyclovir; Anticonvulsants; Antiviral Agents; Child; Clonazepam; Corpus Callosum; Encephalitis, Viral; Female; Humans; Influenza B virus; Influenza, Human; Intracranial Hemorrhages; Magnetic Resonance Imaging; Neurologic Examination; Seizures, Febrile