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Molecular mechanism may explain how fevers spark seizures

It's one of those unavoidable facts of life -- kids get sick and have fevers. Usually, those elevated internal temperatures cause only temporary discomfort, but in some small children they spark convulsions called "febrile seizures."

These convulsions are "scary and very upsetting to parents," said Robert L. Macdonald, M.D., Ph.D., professor and chair of Neurology. They've also been something of an enigma, he said. The epilepsy research community has struggled to understand how fever ignites convulsions and how to treat them.

Macdonald and colleagues including Jing-Qiong Kang, M.D., Ph.D., research assistant professor of Neurology, have now discovered a molecular mechanism that could explain febrile seizures. The research, published March 1st in The Journal of Neuroscience, may lead to new approaches for preventing recurrent febrile seizures in vulnerable children.

Febrile seizures affect as many as one in 15 children worldwide, generally between the ages of 6 months and 6 years. Most children will suffer no long-term consequences from the convulsions, which tend to be generalized -- involving the whole body -- but some will go on to develop epilepsy.

"It has been very controversial through the years: do you treat febrile seizures or not?" Macdonald said. Several studies have investigated treating children with anti-seizure medications such as phenobarbital or sodium valproate to prevent recurrent febrile seizures, but the studies showed only limited benefit to the approach, Macdonald said.

"That idea has gone by the wayside, and it has not been replaced with any rational strategy for preventing or avoiding subsequent febrile seizures," he said. "The promise of knowing what causes the febrile seizures is part of the excitement about this work." Kang got interested in febrile seizures when she was working as a neurologist and epilepsy specialist in her native China.

"I was always impressed by how quickly fevers can
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Source:Vanderbilt University Medical Center


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