Febrile Infection-related Epilepsy Syndrome Treated by Vagus Nerve Stimulation and Ketonic Diet

Abstract

Background: Febrile infection-related epilepsy syndrome is a refractory epilepsy syndrome that predominantly affects children, with a higher incidence in school-age children and is associated with infectious factors. Case report: A 6-year-old boy developed sudden symptoms characterized by fever and a disorder of consciousness, rapidly progressing into drug-refractory status epilepticus (SE). The electroencephalogram revealed diffuse slow-wave activity in the background, with partial seizures originating from the left temporal and occipital regions that gradually generalized. Brain MRI showed no abnormalities in the signal. Due to the failure of multi-drug anti-epileptic therapy, a ketogenic diet was administered and the frequency of seizure was reduced, however, a ketogenic diet was administered, which reduced the frequency of seizures; however, the ketogenic diet treatment was discontinued due to intolerance. After discharge, both the ketogenic diet and anti-seizure medications (ASMs) were administered to the patient. Upon follow-up, occasional seizures were reported, accompanied by unconsciousness and a significant decline in cognitive function compared to the pre-onset period. Conclusions: No specific treatment modality is available for febrile infection-related epilepsy syndrome; however, a ketogenic diet and vagus nerve stimulation (VNS) may offer potential efficacy in controlling acute seizures and improving prognosis.

Keywords

• seizure
• status epilepticus (se)
• ketogenic diet
• vagus nerve stimulation (vns)