Seizure, Febrile
Basics
Description
Description
- 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
- Simple febrile seizures:
- 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
Etiology
Common childhood infections:Etiology
- Upper respiratory illnesses
- Otitis media
- Roseola
- GI infections
- Shigella gastroenteritis
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Citation
Schaider, Jeffrey J., et al., editors. "Seizure, Febrile." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307385/all/Seizure__Febrile.
Seizure, Febrile. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307385/all/Seizure__Febrile. Accessed September 14, 2024.
Seizure, Febrile. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307385/all/Seizure__Febrile
Seizure, Febrile [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2024 September 14]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307385/all/Seizure__Febrile.
* Article titles in AMA citation format should be in sentence-case
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T1 - Seizure, Febrile
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ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
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