Acute encephalopathy with inflammation-mediated status epilepticus

Rima Nabbout, Annamaria Vezzani, Olivier Dulac, Catherine Chiron

Research output: Contribution to journalArticlepeer-review

Abstract

Fever-induced refractory epileptic encephalopathy in school-aged children (FIRES), and idiopathic hemiconvulsion-hemiplegia syndrome (IHHS) are both triggered by fever, although evidence for a causal microorganism or an autoimmune phenomenon is lacking. FIRES begins in school age with status epilepticus lasting several weeks, involves perisylvian areas including mesial temporal structures, and is followed by pharmacoresistant epilepsy with major cognitive deterioration. IHHS begins in infancy with unilateral clonic status epilepticus and is followed by hemiplegia with pharmacoresistant epilepsy. The aetiology of FIRES and IHHS remains unknown, although clinical features and experimental models point to a likely vicious cycle involving inflammation and seizure activity that depends on the stage of brain maturation. We therefore propose to group these conditions under the concept of acute encephalopathy with inflammation-mediated status epilepticus. In addition to preliminary but encouraging clinical observations, there are theoretical reasons to consider the ketogenic diet as an early means to control both seizures and inflammation.

Original languageEnglish
Pages (from-to)99-108
Number of pages10
JournalThe Lancet Neurology
Volume10
Issue number1
DOIs
Publication statusPublished - Jan 2011

ASJC Scopus subject areas

  • Clinical Neurology

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