Evidence map›Paper›PMID 40844418›Full record

ArticleEpilepsia2025

Standard complete blood count to predict long-term outcomes in febrile infection-related epilepsy syndrome (FIRES): A multicenter study.

Martin Guillemaud, Aurélie Hanin, James J Riviello, Mario Chavez, Ayush Batra, Megan Berry, Francesca Bisulli, Carlos Castillo-Pinto, Carla Cobos-Hernandez, Sophie Demeret and 27 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

37 authors.

Martin GuillemaudInstitut du Cerveau, Paris Brain Institute, ICM, INRIA, Inserm, CNRS, AP-HP, Hôpital de la Pitié-Salpêtrière, Sorbonne Université, Paris, France.ORCID https://orcid.org/0009-0002-2523-8712
Aurélie HaninInstitut du Cerveau, Paris Brain Institute, ICM, INRIA, Inserm, CNRS, AP-HP, Hôpital de la Pitié-Salpêtrière, Sorbonne Université, Paris, France.ORCID https://orcid.org/0000-0002-5912-9998
James J RivielloDivision of Neurology and Developmental Neuroscience, Baylor College of Medicine, Houston, Texas, USA.
Mario ChavezInstitut du Cerveau, Paris Brain Institute, ICM, INRIA, Inserm, CNRS, AP-HP, Hôpital de la Pitié-Salpêtrière, Sorbonne Université, Paris, France.ORCID https://orcid.org/0000-0003-0390-4833
Ayush BatraFeinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-4783-5801
Megan BerryDepartment of Neurology, University of Wisconsin, Madison, Wisconsin, USA.
Francesca BisulliIRCCS Istituto Delle Scienze Neurologiche di Bologna-Full Member of the ERN EpiCARE, Bologna, Italy.ORCID https://orcid.org/0000-0002-1109-7296
Carlos Castillo-PintoDivision of Pediatric Neurology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-5228-8574
Carla Cobos-HernandezDepartment of Pediatrics, Section of Neurology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado, USA.
Sophie DemeretNeuro-Intensive Care Unit, Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Sorbonne Université, Paris, France.ORCID https://orcid.org/0000-0002-0523-6472
Krista EschbachDepartment of Pediatrics, Section of Neurology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado, USA.ORCID https://orcid.org/0000-0002-4249-338X
Raquel Farias-MoellerDepartment of Neurology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA.ORCID https://orcid.org/0000-0001-8717-7703
Madeline FieldsIcahn School of Medicine at Mount Sinai, New York City, New York, USA.ORCID https://orcid.org/0000-0003-0661-4153
Nicolas GaspardDepartment of Neurology, Comprehensive Epilepsy Center, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0003-1148-6723
Elizabeth E GerardFeinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0003-3062-8360
Teneille E GoftonSchulich School of Medicine and Dentistry, London Health Sciences Center, Western University, London, Ontario, Canada.ORCID https://orcid.org/0000-0001-9001-4884
Margaret T GopaulDepartment of Neurology, Comprehensive Epilepsy Center, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0002-1329-3258
Matthew D GruenDepartment of Neurology, Comprehensive Epilepsy Center, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0009-0004-0601-7169
Anthony D JimenezDepartment of Neurology, Comprehensive Epilepsy Center, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0009-0002-8706-5423
Karnig KazazianSchulich School of Medicine and Dentistry, London Health Sciences Center, Western University, London, Ontario, Canada.ORCID https://orcid.org/0000-0001-6157-601X
Minjee KimFeinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-2720-1940
Marwa MansourDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Lara MarcuseIcahn School of Medicine at Mount Sinai, New York City, New York, USA.
Clémence MaroisNeuro-Intensive Care Unit, Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Sorbonne Université, Paris, France.ORCID https://orcid.org/0000-0002-3266-0623
Mikaela MoralesDivision of Pediatric Neurology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-0406-4576
Lorenzo MuccioliIRCCS Istituto Delle Scienze Neurologiche di Bologna-Full Member of the ERN EpiCARE, Bologna, Italy.ORCID https://orcid.org/0000-0001-6827-0099
Elena PasiniIRCCS Istituto Delle Scienze Neurologiche di Bologna-Full Member of the ERN EpiCARE, Bologna, Italy.ORCID https://orcid.org/0000-0001-6298-455X
Michelle M PhamDepartment of Pharmacy, Texas Children's Hospital, Houston, Texas, USA.
Santiago Philibert RosasDepartment of Neurology, University of Wisconsin, Madison, Wisconsin, USA.ORCID https://orcid.org/0000-0002-2521-334X
Aaron F StruckDepartment of Neurology, University of Wisconsin, Madison, Wisconsin, USA.ORCID https://orcid.org/0000-0002-9103-1798
Nathan TorcidaDepartment of Neurology, Hôpital Universitaire de Bruxelles-Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium.ORCID https://orcid.org/0009-0004-6208-5035
Mark S WainwrightDivision of Pediatric Neurology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-4736-7462
Ji Yeoun YooIcahn School of Medicine at Mount Sinai, New York City, New York, USA.ORCID https://orcid.org/0000-0001-7242-9779
Eyal MuscalDivision of Neurology and Developmental Neuroscience, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0003-1866-6129
Vincent NavarroInstitut du Cerveau, Paris Brain Institute, ICM, INRIA, Inserm, CNRS, AP-HP, Hôpital de la Pitié-Salpêtrière, Sorbonne Université, Paris, France.ORCID https://orcid.org/0000-0003-0077-8114
Lawrence J HirschDepartment of Neurology, Comprehensive Epilepsy Center, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0002-6333-832X
Yichen LaiDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-9450-5506

Funding

Sleep Health and Cognitive Function among Middle-aged Adults: the SleepCog StudyK23AG088497 · NIA · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Minjee Kim · 2024 to 2026
$575k
Daniel Raymond Wong Neurology FundFFRE-ParatonnerreNIA NIH HHS K23 AG088497NORSE/FIRES Research Fund at Yale
6 · The paper itself

Abstract

objectiveWe investigated whether complete blood count (CBC) analyses during intensive care unit stay could predict 12-month outcomes in patients with cryptogenic febrile infection-related epilepsy syndrome (FIRES), a subset of new-onset refractory status epilepticus (NORSE).

methodsOutcomes at 12 months were classified as "unfavorable" (Glasgow Outcome Score [GOS] 1-3) or "favorable" (GOS 4-5). Demographic, clinical, and serial CBC data were collected across treatment phases: (1) no immunotherapy (before initiation or no treatment), (2) first-line immunotherapy, and (3) second-line immunotherapy. For each treatment phase, predictive models stratified outcomes based on CBC features using decision tree regression, with separate models for adults and children. Model performance was tested using a leave-one-patient-out approach.

resultsWe studied 63 patients (34 adults, 29 children) from 12 centers. Unfavorable outcomes occurred in 18 adults and 12 children. Children were more likely to receive second-line immunotherapy. We analyzed 1530 CBCs (adults: 997 CBCs, including 539 for unfavorable outcomes; children: 533 CBCs, including 415 for unfavorable outcomes). Subgroup analyses revealed differences in CBC levels according to the outcomes and the treatment received. Adults with unfavorable outcomes notably had higher neutrophil-to-lymphocyte ratios (NLRs) and monocyte-to-lymphocyte ratios (MLRs), whereas children with unfavorable outcomes had higher red cell distribution width. NLRs and MLRs increased when CBCs were collected after the initiation of immunotherapy for both adults and children. The variables of interest differed in the different predictive models but always included the proportion of at least one subtype of leukocyte. Prediction accuracy with our models was higher in children (87% overall, with the best performance in no-treatment and first-line phases) than in adults (83% overall, with the best performance during/after the initiation of second-line). SIGNIFICANCE: Findings suggest the potential for standard CBCs to serve as a rapid, accessible tool for early prognostication in cryptogenic FIRES, particularly in children.

Indexed as

Seizures, FebrileStatus EpilepticusAdolescentAdultAgedBlood Cell CountChildChild, PreschoolFemaleHumansImmunotherapyInfantMaleMiddle AgedPredictive Value of TestsPrognosiscomplete blood countFIRESNORSEoutcomes

Identifiers

PMID40844418
PMCPMC12779312

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.