Febrile infection-related Epilepsy Syndrome (FIRES) is an uncommon but severe disorder manifesting a prior febrile infection starting between 2 weeks and 24 h before the onset of the refractory status epilepticus with or without fever at the onset of status epilepticus. Symptoms of FIRES had been previously named as “acute encephalitis with refractory, repetitive partial seizures” or as “fever-induced refractory epileptic encephalopathy in school age children”. In this literature review, Pavone et al. [
184] presented two cases with FIRES and discussed about this rare even though severe disorder. Both cases presented with the classical FIRES symptoms and reported moderate-severe cognitive impairment and persistence of seizures. Clinical manifestations of FIRES are focal seizures in the acute phase with possible secondary generalization, sometimes associated with pallor, apnea, and cyanosis [
185]. Current guidelines for diagnosis of FIRES are not yet available [
186]. Different treatment options have been reported, usually suggested during the second phase of the disease. Most used drugs are intravenous benzodiazepines as midazolam, clonazepam, lorazepam and diazepam in association with standard anticonvulsant drugs, as oral levetiracetam, valproic acid, and lacosamide [
186]. Alternative therapeutic strategies are ketogenic diet immunomodulatory and intravenous steroids at high-dose or immunoglobulins, plasmapheresis and other agents [
187]. Clinical outcomes usually see the persistence of seizure episodes, intellectual disability or, in more severe cases, vegetative state [
188]. FIRES is an uncommon and not yet totally understood entity. Since many aspects of this disease such as pathogenesis and treatment still need to be clarified, further future studies are needed. Epilepsy is a common and serious multifactorial neurologic disease with a strong genetic component [
189]. Ghazala et al. [
190] investigated the SCN1A-A3184G polymorphism among Egyptian children and adolescents with non-lesional epilepsy conducting a prospective case-control observational study. Neuronal voltage-gated sodium channels are involved in the generation and propagation of the action potentials within the neurons, acting on membrane permeability to sodium ions that allows ions diffusion down an electrochemical gradient till the sodium equilibrium potential [
191]. There is evidence about the role of the neuronal voltage-gated sodium channels polymorphisms in the epilepsy pathogenesis that causes a spectrum of epilepsy syndromes. For this reason, sodium-channel blockers such as carbamazepine, oxcarbazepine, phenytoin, lamotrigine, lacosamide and lidocaine are some of the most common therapeutic options for epilepsies due to genetic channelopathies. The SCN1A-A3184G (p.Thr1067Ala) polymorphism has been suggested to be linked with the epilepsy risk in several non-Caucasian populations [
192]. In their study, the authors extracted and analyzed genomic DNA controls and cases. Results of the study report insignificant differences between epilepsy cases and the control group regarding the frequency of SCN1A-A3184G genotypes and allele. Authors also suggest that the identification of SCN1A-A3184G genotypes might help to choose the most suitable antiepileptic drugs. Further studies on a larger scale are needed to better clarify the matter.