FEBRILE SEIZURES

Febrile Seizures Age 6 mo to 6 yr Temp ≥ 38.5°C Neurologically normal exam before and after seizure If < 6 mo, not a febrile seizure → LP If neuro deficits or lethargic on exam → rule out CNS infection → CT, LP Simple Febrile Seizures Generalized < 15 min 1 seizure in 24 hours No investigations for seizure Work-up source of fever (ear exam, consider urinalysis and culture, CBC) ~1/3 risk of future febrile seizure No significant increased risk of epilepsy No brain damage, no impact on intelligence Complex (Atypical) Febrile Seizures Focal ≥ 15 min 1 seizure in 24 hours ~1/3 risk of future febrile seizure Slightly increased risk of epilepsy (4–6%) No brain damage from short (<15 min) seizure EEG Consider CT/MRI, especially if focal features Consider LP (clinical decision; higher threshold to do LP if prolonged seizure, age 6–12 mo, or focal features) Work-up source of fever