[Pre-hospital and hospital treatment of febrile seizures]

Abstract

Introduction: Given that febrile seizures are a common reason for both hospital and pre-hospital visits to physicians, and in the absence of a clear consensus on guidelines for treatment, especially for complex febrile seizures (CFS), we aim to examine their characteristics and treatment in order to improve the approach to the issue.

Patients and methods: This is an observational, retrospective, single-centre study including paediatric patients seen after a seizure associated with a febrile illness in the emergency department of a second-level hospital between September 2021 and December 2023. Epidemiological, clinical and treatment variables were collected.

Results: A total of 266 febrile seizures were included in the study: 188 (70.7%) were simple, and 78 (29.3%) were complex. Most benzodiazepines were administered during pre-hospital treatment (82%), and the transmucosal route was used in 70.3% of cases, despite the patient being in a healthcare environment. Complementary tests were performed in 70.6% of cases, blood tests in 65.6%, and nasopharyngeal swabs for viruses in 79.3%. A total of 73.6% of the tests requested were for patients with a focus of the fever.

Conclusions: Extensive use of complementary tests persists, despite the identification of a focus of the fever in most patients. Our results show that systematic complementary tests and the admission of patients who have presented a CFS would not be justified, and each individual case should be considered.

Figura 1

Tipo, número y resultados de pruebas complementarias realizadas, diferenciando por crisis febriles simples y complejas.

Figura 2

Motivos de ingreso de los casos y porcentaje de cada motivo según el total de ingresos, diferenciando entre crisis febriles simples y complejas.