UMEM Educational Pearls

Category: Pediatrics

Title: Febrile Seizures

Keywords: Ferbrile Seizures, Bacteremia, Fever (PubMed Search)

Posted: 2/15/2008 by Sean Fox, MD (Updated: 10/18/2019)
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Febrile Seizures

  • Diagnosis: Simple vs Complex
    • Simple Febrile Seizure
      • Age = 6mos to 5yrs
      • Single Seizure
      • Generalized
      • Lasting less than 15 minutes
      • Child returns to baseline and has normal neurological exam.
    • Complex Febrile Seizure
      • Same as above, except can be focal seizure or prolonged or with multiple seizures within 24 hours.
      • May indicate a more serious disease process.
  • Etiologies:
    • Viral illnesses are the predominant cause of febrile seizures.
      • Human herpes simplex virus 6 (HHSV-6) has been associated with about 20% of pts with first febrile seizures.
    • Shigella gastroenteritis also has been associated.
    • The rate of serious bacterial infections is similar to those found in pt’s with fever without a source
  • Key Point:
    • Do NOT forget to work-up the fever as you would for the patient’s age!
    • A lower threshold for performing full-sepsis work-up with LP is advocated in those pt’s less than 12 months of age.