ABSTRACT

INTRODUCTION. Viral and bacterial infections accompanied by a rise in temperature (hyperthermia) are among the most common (if not the most common) diseases in the world. These conditions may pose an additional danger to patients with epilepsy, who may experience an increase in seizures during fever. The purpose of this review is to familiarize colleagues with the risk factors for seizures, as well as the nuances of using various classes of drugs in patients with "common" infections accompanied by hyperthermia and comorbid epilepsy.

AIM.  To identify the features of the interaction between epilepsy and diseases (viral and bacterial infections) accompanied by an increase in temperature (hyperthermia).

MATERIALS AND METHODS. Materials and methods. The PubMed databases were analyzed from 1997 to 2025 using the keywords "epilepsy, fever" and the Elibrary scientific library from 2010 to 2025 using the keywords "epilepsy, hyperthermia, fever, acute respiratory viral infections". More than 1,500 articles and 100 meta-analyses were identified, data on the interaction of hyperthermia, fever, intoxication, viral and bacterial infections and epilepsy, the specifics of the use of non-steroidal anti-inflammatory drugs and antibiotics in patients with epilepsy, and the interaction of these classes of drugs with anti-seizure medications were found, summarized and presented in the article.

DISCUSSION. The review presents information on risk factors for epileptic and febrile seizures in adults and children against the background of hyperthermia, the features of the combination and side effects of various classes of drugs for the treatment of infections and epilepsy, respectively.

CONCLUSION. Viral and bacterial infections accompanied by hyperthermia increase the risk of seizures in children and adults with epilepsy and can also cause febrile seizures in children. The main contribution to the provocation of seizures is made by fever and intoxication, to a lesser extent - the direct effect of the infectious agent on the brain, and to an even lesser extent - the side effects of drugs for the treatment of fever and / or infection. For the treatment of epilepsy, drugs with minimal effect on liver metabolism seem to be safer, for the treatment of infection, non-steroidal anti-inflammatory drugs and / or antibiotics are prescribed according to indications, the likelihood of provoking seizures by them is usually much less than the potential benefit.

KEYWORDS: epilepsy, hyperthermia, infections, antiseizure medications, non-steroidal anti-inflammatory drugs, antibiotics

For citation: Kotov A.S, Firsov K.V. Epilepsy and Hyperthermia: a Review. Comorbidity Neurology. 2025; 2 (1): 13-19. https://doi.org/10.62505/3034-185x-2025-2-1-13-19

*For correspondence: Aleksey S. Kotov, Dr. Sci. (Med.), Leading Researcher, Professor of the Department of Neurology, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia. E-mail: alex-013@yandex.ru, ORCID: https://orcid.org/0000-0003-2988-5706

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ADDITIONAL INFORMATION

Aleksey S. Kotov, Dr. Sci. (Med.), Leading Researcher, Professor of the Department of Neurology, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia. E-mail: alex-013@yandex.ru. ORCID: https://orcid.org/0000-0003-2988-5706

Konstantin V. Firsov, Cand. Sci. (Psychol.), Junior Researcher of the Department of Neurology, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia. E-mail: firsovkonst@yandex.ru. ORCID: https://orcid.org/0000-0002-3291-7994

Author contributions. All authors confirm that their authorship complies with the international ICMJE criteria (all authors made a significant contribution to the development of the concept, the conduct of the study and the preparation of the article, read and approved the final version before publication). Special contributions: Kotov A.S. – conceptualization, methodology, formal analysis, writing – review & editing; Firsov K.V. – writing – original draft, formal analysis.

Funding. This study was not supported by any external sources of funding.

Disclosure. The authors declare no apparent or potential conflicts of interest related to the publication of this article.

The content is available under the Creative Commons Attribution 4.0 License.

©2025. Aleksey S. Kotov, Konstantin N. Firsov