Febrile Response And Seizures

Fever is a concerted stress response that is associated with temporarily elevated brain temperature and core body temperature, but it does not involve a change in the temperature set point of the homeotherm animal. Fever is one of the oldest biomarkers; it is dependent on the central nervous system and involves neuronal activity changes in the anterior hypothalamus, hippocampus, and cerebral cortex. Interleukin-1 (IL-1), tumor necrosis factor, and prostaglandin E have all been shown to act as endogenous pyrogens. IL-1β, the most potent endogenous pyrogen, is balanced by the IL-1 receptor antagonist (IL-1Ra). The human recombinant form of IL-1Ra (i.e., anakinra) is an approved anti-inflammatory drug endowed with anticonvulsive effects. High fever is common in children where it may cause febrile seizures in 2%–5% of cases. Although most febrile seizures are benign, prolonged febrile seizures increase the risk of developing epilepsy. Recent evidence showed that anakinra may control unprovoked seizures, initially triggered by fever, in children and adolescents who are not responsive to traditional antiepileptic drugs. The search for genetic and molecular predictors of the long-term consequences of febrile seizures represents an area of active clinical and experimental studies.