Journal of Clinical Pediatrics ›› 2026, Vol. 44 ›› Issue (3): 264-269.doi: 10.12372/jcp.2026.25e0509

• Literature Review • Previous Articles     Next Articles

Clinical application of tocilizumab in febrile infection-related epilepsy syndrome

CHEN Zhe, HONG Siqi()   

  1. Department of Neurology, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child ealth and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China
  • Received:2025-05-07 Accepted:2025-07-23 Published:2026-03-15 Online:2026-03-06

Abstract:

Febrile infection-related epilepsy syndrome (FIRES) is a rare and catastrophic epileptic encephalopathy that predominantly affects school-aged children.Characterized by a biphasic clinical course, FIRES manifests as rapid progression to refractory status epilepticus following a preceding febrile infection. The prognosis of FIRES is dismal: the acute-phase mortality rate is approximately 10%, and survivors often develop chronic refractory epilepsy and cognitive impairment. The pathogenesis of FIRES remains unclear, but neuroinflammation involving cytokines such as IL-6 may play a key role. Tocilizumab, a humanized monoclonal antibody targeting the IL-6 receptor, exerts anti-inflammatory effects by blocking IL-6 signaling. For FIRES patients unresponsive to conventional anti-seizure medications (ASMs), first-line immunotherapies, or ketogenic diet, tocilizumab is currently recommended as a second-line immunotherapeutic option. This review summarizes the background, mechanisms, clinical applications, safety profile, and challenges associated with tocilizumab in FIRES management, aiming to update clinicians on the latest advances in this field..

Key words: febrile infection-related epilepsy syndrome, refractory status epilepticus, interleukin-6, tocilizumab

CLC Number: 

  • R72