January Week 1: Febrile Seizures


Hirtz D. Febrile Seizures. Peds in Review. 1997;18;5

Duffner P, et al. A Synopsis of the American Academy of Pediatrics’ Practice Parameters on the Evaluation and Treatment of Children with Febrile Seizures. Peds in Review. 1999;20:285

Case 1:

You are evaluating a 1 year old male overnight in the ED who was brought in by his parents for loss of consciousness and convulsion. In the ED, temperature is 102. He received his routine immunizations 9 days ago.

What other questions would you ask to differentiate a simple vs complex febrile seizure?
Do the vaccines have any relation to the seizure?

The parents tell you the child starting having fever this evening and he had normal mental status until the seizure occurred. The convulsion was generalized tonic-clonic, symmetric, lasted less than 3 minutes and he quickly regained full baseline mental status.

What parts of the physical examination are most important?
What labs and studies are indicated?
What are indications for hospitalization for febrile seizure?
The parents are worried that their child will have epilepsy. What do you tell them?