Skip to main content
SpringerLink
Log in

Consensus statements on the information to deliver after a febrile seizure

  • Original Article
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

This article has been updated

Abstract

Febrile seizures (FS) are usually self-limiting and cause no morbidity. Nevertheless they represent very traumatic events for families. There is a need to identify key messages that reassure carers and help to prevent inappropriate, anxiety-driven behaviors associated with “fever phobia.” No recommendations have been proposed to date regarding the content of such messages. Using a Delphi process, we have established a consensus regarding the information to be shared with families following a FS. Twenty physicians (child neurologists and pediatricians) from five European countries participated in a three-step Delphi process between May 2018 and October 2019. In the first step, each expert was asked to give 10 to 15 free statements about FS. In the second and third steps, statements were scored and selected according to the expert ranking of importance. A list of key messages for families has emerged from this process, which offer reassurance about FS based on epidemiology, underlying mechanisms, and the emergency management of FS should they recur. Interestingly, there was a high level of agreement between child neurologists and general pediatricians.

Conclusion: We propose key messages to be communicated with families in the post-FS clinic setting.

What is Known:

• Febrile seizures (FS) are traumatic events for families.

• No guidelines exist on what information to share with parents following a FS.

What is New:

• A Delphi process involving child neurologists and pediatricians provides consensual statement about information to deliver after a febrile seizure.

• We propose key messages to be communicated with families in the post-FS clinic setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Change history

  • 26 April 2021

    The citation of the co-author "Victoria San Antonio-Arce" of the above article has been updated from Antonio-Arce, V.S. to San Antonio-Arce, V.

Abbreviations

EEG:

Electroencephalogram

FS:

Febrile seizure

MRI:

Magnetic resonance imaging

References

  1. American Academy of Pediatrics (1996) Provisional Committee on Quality Improvement and Subcomittee on Febrile Seizures. Practice parameter: the neurodiagnostic evaluation of a child with a first simple febrile seizure. Pediatrics 97(5):769–772 discussion 773-775

    Google Scholar 

  2. Berg AT, Shinnar S, Shapiro ED, Salomon ME, Crain EF, Hauser WA (1995) Risk factors for a first febrile seizure: a matched case-control study. Epilepsia 36(4):334–341. https://doi.org/10.1111/j.1528-1157.1995.tb01006.x

    Article  CAS  PubMed  Google Scholar 

  3. Graves RC, Oehler K, Tingle LE (2012) Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician 85(2):149–153

    PubMed  Google Scholar 

  4. Pavlidou E, Panteliadis C (2013) Prognostic factors for subsequent epilepsy in children with febrile seizures. Epilepsia 54(12):2101–2107. https://doi.org/10.1111/epi.12429

    Article  PubMed  Google Scholar 

  5. Westin E, Levander MS (2018) Parent’s experiences of their children suffering febrile seizures. J Pediatr Nurs 38:68–73. https://doi.org/10.1016/j.pedn.2017.11.001

    Article  PubMed  Google Scholar 

  6. Van Stuijvenberg M, de Vos S, Tjiang GC, Steyerberg EW, Derksen-Lubsen G, Moll HA (1999) Parents’ fear regarding fever and febrile seizures. Acta Paediatr 88(6):618–622. https://doi.org/10.1080/08035259950169260

    Article  PubMed  Google Scholar 

  7. Frascari F, Dreyfus I, Chaix Y, Tison-Chambellan C (2017) Efficacy of an interventional educational programme in mitigating post-traumatic stress in parents who have witnessed a febrile seizure: a pilot before-and-after study. BMJ Paediatr Open 1(1):e000107. https://doi.org/10.1136/bmjpo-2017-000107

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wirrel E, Turner T (2001) Parental anxiety and family disruption following a first febrile seizure in childhood. Paediatr Child Health 6(3):139–143

    Article  Google Scholar 

  9. Bertille N, Fournier-Charrière E, Pons G, Chalumeau M (2013) Managing fever in children: a national survey of parents’ knowledge and practices in France. PLoS One 8(12):e83469. https://doi.org/10.1371/journal.pone.0083469

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Chiappini E, Parretti A, Becherucci P, Pierattelli M, Bonsignori F, Galli L, de Martino M (2012) Parental and medical knowledge and management of fever in Italian pre-school children. BMC Pediatr 12:97. https://doi.org/10.1186/1471-2431-12-97

    Article  PubMed  PubMed Central  Google Scholar 

  11. Purssell E (2007) Treatment of fever and over-the-counter medicines. Arch Dis Child 92(10):900–901. https://doi.org/10.1136/adc.2007.118810

    Article  PubMed  PubMed Central  Google Scholar 

  12. Clericetti CM, Milani GP, Bianchetti MG, Simonetti GD, Fossali EF, Balestra AM, Bozzini MA, Agostoni C, Lava SAG (2019) Systematic review finds that fever phobia is a worldwide issue among caregivers and healthcare providers. Acta Paediatr 108(8):1393–1397. https://doi.org/10.1111/apa.14739

    Article  PubMed  Google Scholar 

  13. Kolahi AA, Tahmooreszadeh S (2009) First febrile convulsions: inquiry about the knowledge, attitudes and concerns of the patients’ mothers. Eur J Pediatr 168(2):167–171. https://doi.org/10.1007/s00431-008-0724-z

    Article  PubMed  Google Scholar 

  14. Sajadi M, Khosravi S (2017) Mothers’ experiences about febrile convulsions in their children: a qualitative study. Int J Commun Base Nurs Midwife 5(3):284–291

    Google Scholar 

  15. Bertille N, Purssell E, Corrard F, Chiappini E, Chalumeau M (2016) Fever phobia 35 years later: did we fail? Acta Paediatr 105(1):9–10. https://doi.org/10.1111/apa.13221

    Article  PubMed  Google Scholar 

  16. Schmitt BD (1960) Fever phobia: misconceptions of parents about fevers. Am J Diseas Child 134(1980):176–181

    Google Scholar 

  17. Gunduz S, Usak E, Koksal T, Canbal M (2016) Why fever phobia is still common? Iran Red Crescent Med J 8:e23827. https://doi.org/10.5812/ircmj.23827

    Article  Google Scholar 

  18. Wilmshurst JM, Gaillard WD, Vinayan KP, Tsuchida TN, Plouin P, Van Bogaert P, Carrizosa J et al (2015) Summary of recommendations for the management of infantile seizures: Task Force Report for the ILAE Commission of Pediatrics. Epilepsia 56(8):1185–1197. https://doi.org/10.1111/epi.13057

    Article  PubMed  Google Scholar 

  19. Williams PL, Webb C (1994) The Delphi technique: an adaptive research tool. Br J Occup Ther 61(4):153–156

    Google Scholar 

  20. Hasson F, Keeney S, McKenna H (2000) Research guidelines for the Delphi survey technique. J Adv Nurs 32(4):1008–1015

    CAS  PubMed  Google Scholar 

  21. Capovilla G, Mastrangelo M, Romeo A, Vigevano F (2009) Recommendations for the management of “febrile seizures”: Ad Hoc Task Force of LICE Guidelines Commission. Epilepsia 50

  22. Paul SP, Rogers E, Wilkinson R, Paul B (2015) Management of febrile convulsion in children. Emerg Nurse 23:18–25

    Article  PubMed  Google Scholar 

  23. Laino D, Mencaroni E, Esposito S (2018) Management of pediatric febrile seizures. Int J Environ Res Public Health 15(10):2232

    Article  PubMed Central  Google Scholar 

  24. Armon K, Stephenson T, MacFaul R, Hemingway P, Werneke U, Smith S (2003) An evidence and consensus based guideline for the management of a child after a seizure. Emerg Med J 20(1):13–20. https://doi.org/10.1136/emj.20.1.13

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Availability of data and material

All data is available.

Code availability

Not applicable.

Author information

Authors and Affiliations

  1. APHP. Service de Neurologie Pédiatrique, Hôpital Robert Debré, Paris, France

    Anna Loussouarn, Blandine Dozières-Puyravel & Stéphane Auvin

  2. Université de Paris, INSERM NeuroDiderot, Paris, France

    Anna Loussouarn, Blandine Dozières-Puyravel & Stéphane Auvin

  3. Great North Children’s Hospital Newcastle-upon-Tyne & Translational & Clinical Research Institute Newcastle University, Newcastle, UK

    Anita Devlin

  4. Klinik für Kinder und Jugendliche, Epilepsiezentrum Kork, Kork, Germany

    Thomas Bast

  5. APHP. Service de Pédiatrique, Hôpital Ambroise Paré, Boulogne Billancourt, France

    Grégoire Benoist

  6. ACTIV, Créteil, France & AFPA, Saint Germain en Laye, France

    François Corrard

  7. UCL NIHR BRC Great Ormond Street Institute of Child Health & Great Ormond Street Hospital for Children, London, WCiN 1EH, UK

    Helen Cross

  8. Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesu Children’s Hospital, IRCCS, Member of European Reference Network EpiCARE, Rome, Italy

    Alessandro Ferretti & Nicola Specchio

  9. Clinica Pediatrica Garcia-Sala, Valencia, Spain

    Fernando Garcia-Sala Viguer

  10. Neuroscience Department, Children’s Hospital Anna Meyer-University of Florence, Florence, Italy

    Renzo Guerrini

  11. Children’s Hospital Aschaffenburg-Alzenau, Aschaffenburg, Germany

    Joerg Klepper

  12. Department of General, Paediatrics and Neonatology and Pediatric Cardiology, University Children’s Hospital Düsseldorf, Düsseldorf, Germany

    Thomas Meissner

  13. APHM, Service de Neurologie Pédiatrique, Hopital de la Timone, Marseille, France

    Mathieu Milh

  14. Línea Pediátrica Manso, Institut Català de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain

    Violeta Poltorak

  15. Pediatric Emergency Department, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

    Umberto Raucci

  16. Freiburg Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany

    Victoria San Antonio-Arce

  17. University of Glasgow, University Hospital Wisahw, NHS, Lanarkshire, Glasgow, UK

    Adrian Sie

  18. Neuropediatria y Unidad Multidisciplinar Epilepsia, Valencia, Spain

    Patricia Smeyers

  19. UCL, Great Ormond Street Institute of Child Health, London, UK

    Alastair Sutcliffe

  20. Clinique de l’Epilepsie de l’enfant et de l’adolescent, Service de Neurologie Pédiatrique, Hôpital Roger Salengro, CHRU de Lille, Lille, France

    Adeline Trauffler

Authors
  1. Anna Loussouarn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anita Devlin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas Bast
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Grégoire Benoist
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. François Corrard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Helen Cross
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alessandro Ferretti
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Fernando Garcia-Sala Viguer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Renzo Guerrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Joerg Klepper
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Thomas Meissner
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Mathieu Milh
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Violeta Poltorak
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Umberto Raucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Victoria San Antonio-Arce
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Adrian Sie
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Patricia Smeyers
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Nicola Specchio
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Alastair Sutcliffe
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Adeline Trauffler
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Blandine Dozières-Puyravel
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Stéphane Auvin
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Pr. Auvin, Dr. Loussouarn and Dr. Dozières-Puyravel contributed to the study conception and design. Material preparation, data collection and analysis were performed by Dr. Loussouarn and Pr. Auvin. All authors generate the statements, scored the statements, wrote and edited the tables. The first draft of the manuscript was written by Dr. Loussouarn and Pr. Auvin and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Anna Loussouarn or Stéphane Auvin.

Ethics declarations

Statement of ethical standards

The authors declare appropriate approvals.

Consent to participate

Not applicable.

Consent for publication

All authors approved the publication of this paper and submission to this journal.

Conflict of interest

The authors declare no competing interests.

Additional information

Communicated by Peter de Winter

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

ESM 1

(DOCX 34 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Loussouarn, A., Devlin, A., Bast, T. et al. Consensus statements on the information to deliver after a febrile seizure. Eur J Pediatr 180, 2993–2999 (2021). https://doi.org/10.1007/s00431-021-04067-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-021-04067-2

Keywords

Search

Navigation