Abstract
Febrile infection-related epilepsy syndrome (FIRES) is a catastrophic epileptic encephalopathy
of unknown etiology which occurs predominantly in school-aged children, following
a febrile illness. The term FIRES was first proposed in 2010 by van Baalen et al.
The etiology of FIRES remains elusive, although most believed that it is likely related
to inappropriate activation of the innate immune system. It is often a diagnosis of
exclusion as it lacks specific clinical criteria and/or confirmatory tests. Familiarity
with the range of imaging phenotypes associated with FIRES is crucial as this will
assist timely recognition and institution of appropriate treatment plan. With this
in mind, the author would like to present a rare case of FIRES with extensive subcortical
infarcts, predominantly in the temporo-occipital lobes. This has never been reported
before and may represent a new imaging phenotype of FIRES. A detailed literature review,
focusing on the various pattern of imaging phenotypes, in relation to patients' age
and clinical outcome, will also be included.
Keywords
refractory epilepsy - infection - fever - subcortical infarcts - FIRES
