WHAT IS A FEBRILE SEIZURE?

A febrile seizure is a seizure accompanied by fever,

without central nervous system infection, that occurs
in infants and children 6 through 60 months of age
Most common convulsive event in children younger
than 60 months
 SIMPLE VS COMPLEX FEBRILE SEIZURE
SIMPLE
Lasts for less than 15
minutes
Not recur within the same
febrile illness
Neurologic examination is
normal
No underlying CNS infection
COMPLEX
duration is >15 min
repeated convulsions occur
within 24 hr
focal seizure activity or focal
findings are present during
the postictal period
DIAGNOSIS
Lumbar puncture should be performed in all children
below 18 months for a simple febrile seizure

For children more than 18 months of age, lumbar

puncture should be performed in the presence of
clinical signs of meningitis
DIAGNOSIS
Children with febrile seizures, lumbar puncture for CSF analysis is
performed to rule out meningitis
CSF analysis is the gold standard for diagnosis of meningitis
Major signs of meningitis
Nuchal rigidity
Coma
Petechiae
Minor signs of meningitis
Persisting drowsiness
Paralysis on examination
DIAGNOSIS
Neuroimaging studies (cranial ultrasound, CT scan,
MRI) should not be routinely performed in children
for a simple febrile seizure
No study has been done investigating the utility of
neuroimaging in children with simple febrile seizure
in children with simple febrile seizure
DIAGNOSIS
RECOMMENDATION ON THERAPEUTIC INTERVENTION
Antipyretic agents are used to control fever and not be relied upon
to prevent recurrence
There is little evidence that prophylactic use of antipyretics has
any effect in reducing the incidence of febrile convulsion
Acetaminophen(10 mg/kg/dose) and ibuprofen (5 mg/kg/dose)
are effective antipyretic agents
Little evidence that use of antipyretics has any effect in reducing
the incidence of febrile convulsion
 Use of continuous anticonvulsant is not recommended in
children after a first simple febrile seizure.
Although anticonvulsants can reduce recurrence of febrile
convulsion, the adverse side effects of these do not warrant their use
in this benign disorder
Electroencephalogram should not be routinely requested in children
with a first simple febrile convulsion
Evidences show that it does not reliably predict recurrence of
febrile seizure