This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Little is known about first-time nonfebrile seizures occurring in the setting of mild acute infectious illness (nonfebrile illness seizures) as these patients have traditionally been excluded from large epidemiological studies of both febrile and unprovoked seizures as they are not easily classified using the international classification system. Only two systematic studies (both retrospective) have been published: one set in Singapore and one performed by our research group (Zerr et al. Epilepsia 2005;46:952-55). Results from both studies suggest that first-time nonfebrile illness seizures occur as often as first-time unprovoked seizures and that diarrhea characterizes the illness accompanying nonfebrile illness seizures more frequently than febrile seizures, suggesting that specific pathogens play a role. A prospective study is needed to: 1) confirm the above findings, 2) explore viral etiologies of nonfebrile seizures, and 3) describe the prognosis of nonfebrile illness seizures. To this end we propose a prospective pilot study. We will enroll 120 patients who present to the ED with first-time seizures: febrile, nonfebrile-illness, or unprovoked. Human specimens will be tested for a variety of viral pathogens. Subjects will be followed for subsequent seizures for 5 years. Data from this study 1) will provide clinicians with guidance and context when managing patients with nonfebrile illness seizure, 2) will serve as pilot data for an NIH application to further study these questions via a multicenter study, and 3) has the potential to inform our understanding of the pathogenesis of seizures. Pilot grants are pending at the Thrasher Research Fund and the NIH.
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