Purpose: Febrile seizures are the most prevalent type of pathological brain activity in children. Despite of the high prevalence, there is still a lot to learn, especially in terms of pathophysiological mechanisms and long term consequences. One of the most controversial topics today is whether febrile seizures lead to temporal lobe epilepsy (TLE). This review study focuses on the pathogenesis of febrile seizures and the possible link between febrile seizures and temporal lobe epilepsy.
Methods: Searches performed using Pubmed.
Results: Linkage and association studies have found numerous loci that may influence the occurrence febrile seizures. Other possible factors in the pathogenesis might be characteristics of cytokines, viral exposure, hyperventilation, iron deficiency or fluid balance. When it comes to febrile seizures and temporal lobe epilepsy retrospective studies find a strong connection between TLE and antecedent febrile seizures. Genetic association studies have also found different loci that can be linked to TLE, with a higher prevalence in those with previous febrile seizures. Animal studies show multiple changes in hippocampal areas after experimental seizures, leading to spontaneous seizures and possible TLE. However, some of the prospective studies fail to show this association.
Conclusion: Many questions still remain unsolved. To come closer to an answer, larger MRI studies and prospective studies with long term follow up are necessary.