Zhang Yi, Ding Chang-Hong, Li Hua, Wang Xiao-Hui, Chen Chun-Hong, Fang Fang
Department of Neurology, Neurological Center, Beijing Children's Hospital, Capital Medical University/National Center for Children's Health, Beijing 100045, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2023;25(9):923-928. doi: 10.7499/j.issn.1008-8830.2304049.
To investigate the electroencephalogram (EEG) characteristics and progression of febrile infection-related epilepsy syndrome (FIRES) in children, aiming to enhance diagnosis and treatment approaches.
A retrospective analysis was conducted on 26 children with FIRES between May 2017 and December 2021.
All 26 children (100%) presented with fever at the onset, followed by frequent convulsions that rapidly progressed into convulsive status. Ventilator support was required for 22 cases (85%). During the acute phase, EEG features demonstrated the disappearance of background activity and physiological sleep cycles in all children. Diffuse slow waves and multifocal slow spike slow waves were observed as abnormal waves during the interictal period. A characteristic pattern of focal low amplitude fast wave initiation was detected in all children during seizure episodes. In the chronic phase, the background EEG activity gradually recovered, and the presence of abnormal waves was relatively limited. The characteristic pattern of focal slow wave rhythm initiation was evident during seizure episodes. Additionally, extreme δ brushes were observed in four cases (15%).
These findings suggest that EEG manifestations in children with FIRES exhibit distinctive patterns during the acute and chronic stages, providing significant value for early diagnosis and clinical staging. Extreme δ brushes may be one of the distinctive markers of children with FIRES.
探讨儿童发热感染相关癫痫综合征（FIRES）的脑电图（EEG）特征及病情进展，旨在提高诊断和治疗方法。
对2017年5月至2021年12月期间的26例FIRES患儿进行回顾性分析。
26例患儿（100%）起病时均有发热，随后频繁惊厥并迅速进展为惊厥持续状态。22例（85%）需要呼吸机支持。急性期，所有患儿脑电图特征显示背景活动和生理睡眠周期消失。发作间期观察到弥漫性慢波和多灶性慢棘慢波为异常波。发作期所有患儿均检测到局灶性低幅快波起始的特征性模式。慢性期，脑电图背景活动逐渐恢复，异常波的存在相对局限。发作期局灶性慢波节律起始的特征性模式明显。此外，4例（15%）观察到极慢波刷。
这些发现表明，FIRES患儿的脑电图表现在急性期和慢性期呈现出独特的模式，对早期诊断和临床分期具有重要价值。极慢波刷可能是FIRES患儿的独特标志之一。
