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.