Seizure, Febrile

Basics

Occurs between 6 mo and 5 yr of age associated with fever:
- No evidence of intracranial infection or other defined CNS primary cause
- Average age of onset is 18–22 mo
- Children with previous nonfebrile seizures excluded
Most common pediatric convulsive disorder:
- Affects 2–4% of young children in the U.S.
Occurs in normal children with a systemic viral illness
High-risk children:
- History of febrile seizure in immediate family members
- Delayed neurologic development
- Males
Subgroups:
- Simple febrile seizures:
  - Brief, self-limited, lasting <10–15 min, resolve spontaneously
  - Generalized without any focal features
- Complex febrile seizures:
  - Duration >15 min
  - Focal features
  - >1 seizure within a 24-hr period
Risk of recurrence:
- One-third of cases
- Early age of onset, history of febrile or afebrile seizures in first-degree relatives, and temperature <40°C during initial seizure increase the likelihood of recurrence
Risk of subsequent epilepsy:
- Greatest for those with prior abnormal neurologic development, a complex (>15 min) first febrile seizure, a focal seizure, or a family history of afebrile seizures
- Only slightly greater than the general population if first febrile seizure is simple and neurologic development normal
- Not affected by the use of prophylactic medications

ALERT
Because this is usually self-limited, intervention must be individualized in relation to airway, breathing, and seizure management

Common childhood infections:

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