Febrile Seizures

Febrile seizures are the most common neurologic disorder in infants and younger children. Most febrile seizures last less than 15 minutes and do not recur within a 24 hour period. Approximately 33% of those affected will have a recurrence in young adulthood. 

Epilepsy prevalence is increased in those with a history of complex febrile seizures. 

Risk Factors

The risk factors for febrile seizure include high fever, viral infections, recent immunizations (specifically with MMR tetanus, pertussis, diphtheria) and genetic predisposition.

Symptoms

Febrile seizures are characterized by fevers and seizures that occur in children. There may or may not be shaking involved. 

Diagnosis

The criteria for febrile seizures include the following: 

-Fever with a convulsion

->6 months but <5 years old 

-Absence of neurological infection or inflammation 

-Absence of metabolic disorder 

-No history of afebrile seizures 

There are two types of febrile seizures, simple and complex

Simple 

<15 minutes

Do not recur in a 24 hours period 

Complex 

>15 minutes

May occur within a 24 hour period 

Shaking to one limb or one side side of the body 

A lumbar puncture, imaging and labs may be considered depending on the symptoms to exclude other diagnoses. 

Treatment

It is very important to reduce fever with antipyretic medications. 

If the seizure is ongoing then medications may be needed to stop the seizure. 

Most children do not need to be hospitalized after a simple febrile seizure, once symptomatically improved they can go home with a followup with their pediatrician. 

Those with complex febrile seizures may require a longer observation period in the hospital.