Complicated Febrile Convulsions In An Identical Twin. Risk For Mesial Temporal Lobe Epilepsy

The case of an identical twin who had a prolonged febrile convulsion at the age of 8 months and developed left mesial temporal lobe epilepsy at the age of 2 years, with left mesial temporal lobe sclerosis in the MRI, is presented. The unaffected twin had frequent short febrile convulsions, and, at the age of 4 years, several hours of unresponsiveness after short febrile convulsions in the course of meningitis; his MRI was normal including T2 relaxometry. We conclude, analogous to other studies, that prolonged febrile convulsions in children younger than 4 years increase the risk of subsequent mesial temporal lobe epilepsy. Our case also illustrates a genetic component in the occurrence of febrile convulsions.