GuidelinesOther guideline
Febrile Seizures
Febrile Seizures
Typical (simple) febrile seizures
Typical (simple) febrile seizures
- 6 months to 6 years old
- Temperature > 38 °C
- Generalised; short-lived seizures (5-10 mins)
- Only 1 seizure in 24 hour period
- No focal features (no Todd’s Paresis)
- Previous normal development
- Source of sepsis evident outside the CNS
Common Associations
- May be a family history of febrile seizure.
- Associated with Roseola, otitis media, URTI, gastro, pneumonia.
Investigations
- Dextrostix (check glucose)
- Check blood pressure
- LP if < 18 months of age, no obvious source of fever, or any suspicion of meningitis and no contraindications to LP.
- Look for cause of fever
Treatment
- Treat cause of fever
- Do not need admission if diagnosis is clear and underlying condition manageable as an outpatient.
- Treat subsequent fevers early and aggressively (Paracetamol; tepid sponging)
- Reassure parents. Seizure itself not damaging, may reoccur and not epilepsy.
Advice
- Teach first aid for seizure
- Call ambulance if seizures lasts > 5 minutes (unless known with severe MR and seizures)
- Do not leave unattended in bath or high risk areas
Complex febrile seizures
- Lasts > 15 minutes
- Multiple seizures within illness
- May be focal
- Have post ictal state associated
- Associated with focal neurology or Todd’s Paresis
- Marginal increase in risk of developing epilepsy – especially if family history of seizures
- Investigation of seizures and long term anticonvulsant may be necessary if many atypical features