# Identification of Genetic Variants in Status Epilepticus Associated With Fever

## TL;DR

This study finds that genetic variants are less common in children with fever-related seizures (SEF) compared to those with developmental and epileptic encephalopathy (DEE).

## Contribution

The study is the first to compare genetic variant detection rates between SEF and DEE.

## Key findings

- Genetic variants were detected in 26.7% of SEF cases and 63.0% of DEE cases.
- SEF cases only showed SCN1A variants, while DEE cases involved 16 different genes.
- SEF and DEE may have distinct mechanisms for seizure onset.

## Abstract

Status epilepticus associated with fever (SEF) is often encountered in pediatric emergency departments, and some patients develop neurological emergencies, such as acute encephalopathy (AE). Although numerous genetic variants of developmental and epileptic encephalopathy (DEE) have been reported, the frequency of these disease‐associated variants of SEF is unknown. The first aim of this study was to investigate the associated genetic variants of SEF. The second aim was to compare the variations in genes between SEF and DEE.

This retrospective, clinical observational study included patients with SEF or DEE who visited Kobe University Hospital or Kobe University affiliated hospitals and provided consent for a genetic diagnosis of SEF or DEE between January 1, 2021, and December 31, 2022.

Fifteen patients with SEF and 27 patients with DEE consented to a genetic diagnosis and were included in the study. The detection rate of genetic variants was lower in patients with SEF (26.7%) than in those with DEE (63.0%), although there is no statistically significant difference (p = 0.05, Fisher's exact test). Analysis of patients with DEE revealed a wide variety of causative genes for DEE (16 different genes), whereas in SEF cases, only SCN1A variants were detected.

Our study is the first to clarify the detection rates of different genetic variants in SEF. Patients with SEF may have less genetic involvement in the onset of epileptic seizures, compared to those with DEE.

The detection rate of genetic variants was lower in patients with status epilepticus associated with fever (SEF) (4/15; 26.7%) than in those with DEE (17/27 63.0%). DEE revealed a wide variety of causative genes (16 different genes), whereas in SEF cases, only SCN1A variants were detected. SEF and DEE may have different onset mechanisms.