pediatrics
Febrile Seizures
Key Points
Febrile seizures are seizures that occur in neurologically normal children 6 months to 5 years of age with fever>38°C that is not caused by a central nervous system infection and who have no previous afebrile seizures. Simple febrile seizures last<15 minutes, have no focal features, and do not recur within a 24-hour period. Complex febrile seizures last≥15 minutes continuously or with pauses; or have focal features; or focal onset; or recur within 24 hours. Routine testing is not required for simple febrile seizures, but if children have complex seizures, neurologic deficits, or signs of a serious underlying disorder (eg, meningitis, metabolic disorders), testing should be done. Seizures lasting≥5 minutes require medication (eg,lorazepam0.05 to 0.1 mg/kg IV over 2 to 5 minutes repeated every 5 to 10 minutes for up to 3 doses). Risk of developing an afebrile seizure disorder after having a simple febrile seizure is about 2 to 5%. Giving an antipyretic at the beginning of a febrile illness has not been shown to prevent a febrile seizure. 