Fits and Starts: Researchers Investigate Workings of and Treatment for Febrile Seizures

Jeannette Y. Wick, RPh, MBA, FASCP
Published Online: Thursday, August 22, 2013
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Two recent studies shed new light on potential treatments for febrile seizures, the most common seizure form in children younger than 5 years old.
Febrile seizures are the most common form of seizures in children younger than 5 years old, affecting approximately 5% of the age group. Some affected children may have genetic epilepsy syndromes triggered by fever, while some may suffer from an idiopathic form of the condition. Febrile seizures, which occur when susceptible children develop hyperthermia above 100.4 degrees F (38 degrees C), terrify parents.

Their typical manifestations include full-body convulsions that last anywhere from a few seconds to minutes. Febrile seizures are usually benign, but serious ones can have negative long-term consequences on brain development. In addition, children who have febrile seizures are at increased risk for seizure disorders later in life. Researchers have been unable to determine why increasing body temperature causes seizures in these children, and there are currently few effective treatments are available.

Febrile seizures are considerably different than other seizures, which are treated with drug therapy that targets and blocks sodium channels, but 2 recent studies have added to the accumulating knowledge regarding febrile seizures. A study published in the European Journal of Paediatric Neurology investigated the effectiveness of antipyretics in preventing febrile seizures in children who had experienced them in the past. The researchers identified 3 previous studies using a literature search. The studies included a total of 540 children, of whom 348 received antipyretics and 192 received placebo. In both groups, 22% to 24% of patients had a subsequent febrile seizure, indicating that antipyretics are an ineffective prophylaxis.

The other study, published in the June 12, 2013, issue of the Journal of Neuroscience, presented a mechanism that may explain febrile seizures and identified a potential new therapeutic target for treating them. Researchers from the Northwestern University Feinberg School of Medicine found that activation of L-type calcium channels, which are sensitive to temperature, seems to drive the electrical activity involved in the seizures. Previously, most researchers believed that L-type calcium channels were unengaged in central nervous system electrical activity. The researchers also found that the L-type calcium-channel blocker nimodipine dramatically reduced the incidence and duration of febrile seizures in rat pups. Several drugs that block L-type calcium channel are FDA-approved, although few have been tested in children and none have been tested for febrile seizures.

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.
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