Febrile seizures

Abstract

Background: Febrile convulsions, or febrile seizures, are frequently encountered in paediatrics, and despite often being self limiting, these seizures strike fear in the hearts of patients' carers.

Objective: This article reviews the assessment and management of febrile seizures in children.

Discussion: The initial assessment of a child who convulses with fever should be directed at finding a cause for the fever, rather than the seizure itself, once the seizure has abated. A lumbar puncture should be performed if there is clinical suspicion of meningitis. Electroencephalograms and neuroimaging studies are not routinely indicated. Overall, febrile seizures carry a good prognosis, although one-third of children have recurrent attacks. Febrile seizures are genetic in origin. The risk of later epilepsy is small but increased if the child has a complex febrile seizure, neurological deficit, or a family history of epilepsy. Carers should be counselled in the management of seizures. The effectiveness of prophylactic treatment with medication remains controversial.