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Symptom-Based Approach to Pediatric Neurology pp 141–153Cite as

Child with Febrile Seizures

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Abstract

Febrile seizures are the most common form of convulsive seizures in children less than 5 years of age. The diagnosis of febrile seizure is made by meticulous history-taking and clinical examination as well as ruling out other potential causes of seizures. Most children do not need further laboratory or radiological testing. The risk of epilepsy in children with febrile seizures is low. Recurrence of febrile seizures can be seen in less than a third of children. Once a diagnosis is made, treatment is focused on parental reassurance and developing a contingency plan for seizure management in case of recurrence. This chapter will review the current knowledge about febrile seizures with emphasis on approach to diagnosis and the principles of management.

Keywords

  • Seizure
  • Fever
  • Meningitis
  • Status epilepticus
  • Recurrence
  • Epilepsy

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References

  1. Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia. 1994;35:S1–6.

    CrossRef  Google Scholar 

  2. Vestergaard M, Pedersen CB, Sidenius P, Olsen J, Christensen J. The long-term risk of epilepsy after febrile seizures in susceptible subgroups. Am J Epidemiol. 2007;165(8):911–8.

    CrossRef  Google Scholar 

  3. Berg AT. Febrile seizures and epilepsy: the contributions of epidemiology. Paediatr Perinat Epidemiol. 1992;6(2):145–52.

    CrossRef  CAS  Google Scholar 

  4. Wolf SM, Forsythe A. Epilepsy and mental retardation following febrile seizures in childhood. Acta Paediatr. 1989;78(2):291–5.

    CrossRef  CAS  Google Scholar 

  5. Berg AT, Shinnar S. Unprovoked seizures in children with febrile seizures: short-term outcome. Neurology. 1996;47(2):562–8.

    CrossRef  CAS  Google Scholar 

  6. Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med. 1987;316(9):493–8.

    CrossRef  CAS  Google Scholar 

  7. Commission on Epidemiology and Prognosis, International League Against Epilepsy. Guidelines for epidemiologic studies on epilepsy. Epilepsia. 1993;34(4):592–6.

    Google Scholar 

  8. Subcommittee on Febrile Seizures. Febrile seizures: guideline for the neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011;127(2):389–94.

    CrossRef  Google Scholar 

  9. Berg AT, Shinnar S, Hauser WA, Alemany M, Shapiro ED, Salomon ME, Crain EF. A prospective study of recurrent febrile seizures. N Engl J Med. 1992;327(16):1122–7.

    CrossRef  CAS  Google Scholar 

  10. Hesdorffer DC, Shinnar S, Lewis DV, Moshé SL, Nordli DR Jr, Pellock JM, MacFall J, Shinnar RC, Masur D, Frank LM, Epstein LG. Design and phenomenology of the FEBSTAT study. Epilepsia. 2012;53(9):1471–80.

    CrossRef  Google Scholar 

  11. Shinnar S, Glauser TA. Febrile seizures. J Child Neurol. 2002;17(1_suppl):S44–52.

    CrossRef  Google Scholar 

  12. van den Berg BJ, Yerushalmy J. Studies on convulsive disorders in young children: I. Incidence of febrile and nonfebrile convulsions by age and other factors. Pediatr Res. 1969;3(4):298–304.

    CrossRef  Google Scholar 

  13. Verity CM, Butler NR, Golding J. Febrile convulsions in a national cohort followed up from birth. I—Prevalence and recurrence in the first five years of life. Br Med J (Clin Res Ed). 1985;290(6478):1307–10.

    CrossRef  CAS  Google Scholar 

  14. Tsuboi T. Epidemiology of febrile and afebrile convulsions in children in Japan. Neurology. 1984;34(2):175–81.

    CrossRef  CAS  Google Scholar 

  15. Stanhope JM, Brody JA, Brink JA, Brink E, Morris CE. Convulsions among the Chamorro People of Guam, Mariana Islands: II. Febrile convulsions. Am J Epidemiol. 1972;95(3):299–304.

    CrossRef  CAS  Google Scholar 

  16. Berg AT, Shinnar S. Complex febrile seizures. Epilepsia. 1996;37(2):126–33.

    CrossRef  CAS  Google Scholar 

  17. Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child. 2004;89(8):751–6.

    CrossRef  CAS  Google Scholar 

  18. Berg AT, Shinnar S, Darefsky AS, Holford TR, Shapiro ED, Salomon ME, Crain EF, Hauser AW. Predictors of recurrent febrile seizures: a prospective cohort study. Arch Pediatr Adolesc Med. 1997;151(4):371–8.

    CrossRef  CAS  Google Scholar 

  19. Offringa M, Bossuyt PM, Lubsen J, Ellenberg JH, Nelson KB, Knudsen FU, Annegers JF, El-Radhi AS, Habbema JD, Derksen-Lubsen G, Hauser WA. Risk factors for seizure recurrence in children with febrile seizures: a pooled analysis of individual patient data from five studies. J Pediatr. 1994;124(4):574–84.

    CrossRef  CAS  Google Scholar 

  20. Raspall-Chaure M, Chin RF, Neville BG, Bedford H, Scott RC. The epidemiology of convulsive status epilepticus in children: a critical review. Epilepsia. 2007;48(9):1652–63.

    CrossRef  Google Scholar 

  21. Hauser WA, Annegers JF, Anderson VE, Kurland LT. The risk of seizure disorders among relatives of children with febrile convulsions. Neurology. 1985;35(9):1268–73.

    CrossRef  CAS  Google Scholar 

  22. Corey LA, Berg K, Pellock JM, Solaas MH, Nance WE, DeLorenzo RJ. The occurrence of epilepsy and febrile seizures in Virginian and Norwegian twins. Neurology. 1991;41(9):1433–6.

    CrossRef  CAS  Google Scholar 

  23. Tsuboi T, Endo S. Genetic studies of febrile convulsions: analysis of twin and family data. Epilepsy Res Suppl. 1991;4:119–28.

    CAS  Google Scholar 

  24. Berg AT, Shinnar S, Shapiro ED, Salomon ME, Crain EF, Hauser WA. Risk factors for a first febrile seizure: a matched case-control study. Epilepsia. 1995;36(4):334–41.

    CrossRef  CAS  Google Scholar 

  25. Vestergaard M, Wisborg K, Henriksen TB, Secher NJ, Østergaard JR, Olsen J. Prenatal exposure to cigarettes, alcohol, and coffee and the risk for febrile seizures. Pediatrics. 2005;116(5):1089–94.

    CrossRef  Google Scholar 

  26. Vestergaard M, Basso O, Henriksen TB, Østergaard JR, Olsen J. Risk factors for febrile convulsions. Epidemiology. 2002;13(3):282–7.

    CrossRef  Google Scholar 

  27. Hartfield DS, Tan J, Yager JY, Rosychuk RJ, Spady D, Haines C, Craig WR. The association between iron deficiency and febrile seizures in childhood. Clin Pediatr. 2009;48(4):420–6.

    CrossRef  Google Scholar 

  28. Camfield P, Camfield C. Febrile seizures and genetic epilepsy with febrile seizures plus (GEFS+). Epileptic Disord. 2015;17(2):124–33.

    CrossRef  Google Scholar 

  29. Dravet C. The core Dravet syndrome phenotype. Epilepsia. 2011;52(Suppl 2):3–9.

    CrossRef  Google Scholar 

  30. Rossetti AO, Tosi C, Despland PA, Staedler C. Post-ictal fever: a rare symptom of partial seizures. Eur J Neurol. 2007;14(5):586–90.

    CrossRef  CAS  Google Scholar 

  31. Joffe A, McCormick M, DeAngelis C. Which children with febrile seizures need lumbar puncture?: a decision analysis approach. Am J Dis Child. 1983;137(12):1153–6.

    CrossRef  CAS  Google Scholar 

  32. Murata S, Okasora K, Tanabe T, Ogino M, Yamazaki S, Oba C, Syabana K, Nomura S, Shirasu A, Inoue K, Kashiwagi M. Acetaminophen and febrile seizure recurrences during the same fever episode. Pediatrics. 2018;142(5):e20181009.

    CrossRef  Google Scholar 

  33. Offringa M, Newton R, Cozijnsen MA, Nevitt SJ. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2017;2(2):CD003031.

    Google Scholar 

  34. Steering Committee on Quality Improvement and Management, Subcommittee on Febrile Seizures. Febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics. 2008;121(6):1281–6.

    CrossRef  Google Scholar 

  35. Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med. 1976;295(19):1029–33.

    CrossRef  CAS  Google Scholar 

  36. Lewis DV, Shinnar S, Hesdorffer DC, Bagiella E, Bello JA, Chan S, Xu Y, MacFall J, Gomes WA, Moshé SL, Mathern GW. Hippocampal sclerosis after febrile status epilepticus: the FEBSTAT study. Ann Neurol. 2014;75(2):178–85.

    CrossRef  Google Scholar 

  37. Verity CM, Greenwood R, Golding J. Long-term intellectual and behavioral outcomes of children with febrile convulsions. N Engl J Med. 1998;338(24):1723–8.

    CrossRef  CAS  Google Scholar 

  38. Nørgaard M, Ehrenstein V, Mahon BE, Nielsen GL, Rothman KJ, Sørensen HT. Febrile seizures and cognitive function in young adult life: a prevalence study in Danish conscripts. J Pediatr. 2009;155(3):404–9.

    CrossRef  Google Scholar 

  39. Capovilla G, Mastrangelo M, Romeo A, Vigevano F. Recommendations for the management of “febrile seizures” ad hoc task force of LICE guidelines commission. Epilepsia. 2009;50:2–6.

    CrossRef  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Neurology, Dayton Children’s Hospital, Dayton, OH, USA

    Rajkumar Agarwal

  2. Wright State University Boonshoft School of Medicine, Dayton, OH, USA

    Rajkumar Agarwal & Roshani Agarwal

  3. Division of Hospital Medicine, Dayton Children’s Hospital, Dayton, OH, USA

    Roshani Agarwal

Authors
  1. Rajkumar Agarwal
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  2. Roshani Agarwal
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Correspondence to Rajkumar Agarwal .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA

    Deepak M. Kamat

  2. Pediatrics and Neurology, Central Michigan University Children’s Hospital of Michigan, Detroit, MI, USA

    Lalitha Sivaswamy

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Agarwal, R., Agarwal, R. (2022). Child with Febrile Seizures. In: Kamat, D.M., Sivaswamy, L. (eds) Symptom-Based Approach to Pediatric Neurology . Springer, Cham. https://doi.org/10.1007/978-3-031-10494-7_9

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  • DOI: https://doi.org/10.1007/978-3-031-10494-7_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-10493-0

  • Online ISBN: 978-3-031-10494-7

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