The significance of febrile seizures in patients with partial seizures operated on because of therapy resistance: Clinical findings in comparison with a control group

Twenty-four (22.4%) out of 107 patients with partial seizures, operated on because of therapy resistance, had suffered from febrile seizures (FS). Of these patients, 66.7% were adults at the date of surgery. In the first year of life, 45.8% suffered their first FS. Only one FS was observed in one-half of the patients and >six FS in three patients. Seizures of >15 minutes duration occurred in 11 of 16 patients, from whom information was available. A duration of >30 minutes was seen in eight patients. Localized or lateralized seizures were observed in seven of 16 patients. Summarizing the various findings, two-thirds of our patients had complicated FS. A family history of epileptic or FS was found in 21.4%, febrile and epileptic convulsions being present in 50% each. Perinatal risk factors were reported in 55%. Three patients attended a special kindergarten and four a school for retarded children. The occupational development was not always without complications. Seven patients showed a mostly slight intellectual deficit, eleven a likewise mostly slight behavior disorder, and five patients mostly slight neurologic deficits. The first epileptic seizure occurred in more than one-third of the patients up to the fifth year of life, in two-thirds up to the 10th year of life. The interval to the last FS was in one-third of the patients up to one half, in approximately two-thirds up to five years. Twenty-three X temporal lobe seizures, 1 X frontal lobe seizures, and 1 X a Rasmussen syndrome (with temporal lobe seizures) were diagnosed. After surgery, 38.1% of the patients became completely seizure free, including also those with only isolated auras 52.4%. Comparing the findings of patients with and without FS, the former appeared more benign in many aspects. The relationship between complicated FS and complex partial seizures is discussed in detail. Three etiologic possi- bilities are presented: complicated FS are the direct cause of complex partial seizures; birth disorders lead to complicated FS as well—later on—complex partial seizures, the complicated FS possibly causing an additional brain disorder; or prenatal disorders can be followed by birth disorders or not and can later on cause FS and subsequent complex partial seizures. Possibly all factors can play a role. In some cases additional effects might be responsible.