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Febrile Seizures

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Book cover Clinical Manual of Fever in Children

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  • #x203A; Attacks precipitated by fever can be epileptic or non-epileptic.

  • › Children with febrile seizures (FSs) are not considered to have epilepsy since their seizure only occurs when the child is febrile (acute symptomatic seizure).

  • › FSs do not constitute a homogeneous entity.

  • › The cumulative incidence of FSs in most countries is 2–5%.

  • › FSs usually occur between 6 months and 3 years. They peak at 18 months and it is rare for their onset to be after 6 years of age.

  • › FSs are divided into simple and complex. The latter have focal features and/or are prolonged and/or are repeated in the same illness.

  • › Viral illnesses, particularly human herpes virus 6, precipitate most FSs.

  • › One third of children who have one FS will have at least one recurrence.

  • › Recurrent FSs are more likely if the child was young at the time of the first seizure, the fever provoking the first seizure was relatively low, the child suffers from a lot of illness episodes and has a family history of FS.

  • › The risk of epilepsy following FSs is 7% at 25 years.

  • › Following one or more FS, risk factors for developing epilepsy are family history of epilepsy, neurodevelopmental problems and complex FS.

  • › The risk that a child with a FS will have bacterial meningitis is 0-4%.

  • › Routine brain imaging and EEG is not indicated following a FS.

  • › Regular prophylactic medication to prevent recurrent FSs is not recommended but rectal diazepam or buccal midazolam may be useful to stop further prolonged FSs.

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Editor information

Editors and Affiliations

  1. Consultant Paediatrician & Honorary Senior Lecturer, Medical School Denver Close Petts Wood, Orpington Kent, BR6 OSB, UK

    A. Sahib El-Radhi FRCPCH, MRCP,Ph.D, DCH

  2. Professor of Neurology, Pediatrics, and Biochemistry, and Molecular Biology Vice-Chairman, Department of Neurology Chief, Section of Pediatric Neurology, The Medical College of Georgia, 1120 15th Street Augusta, Georgia, 30912, USA

    James Carroll MD

  3. Division of Cell and Molecular Biology Institute of Child Health, Senior Lecturer and Honorary Consultant in Infection and Immunology, 30 Guilford Street, London, WC1N 1EH, UK

    Nigel Klein MBBS, BSc, PhD, MRCP, FRCPCH

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(2009). Febrile Seizures. In: El-Radhi, A.S., Carroll, J., Klein, N. (eds) Clinical Manual of Fever in Children. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-78598-9_7

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  • DOI: https://doi.org/10.1007/978-3-540-78598-9_7

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