Febrile seizures:

Epidemiology: MC aged 6 mo to 5 years

-

MC seizures in childhood

Risk factors (1st time):

-

Day care
Developmental delay
Viral infections
o Human herpes 6 MC
Also influenza, adenovirus
Vitamin deficiency:
o Fe
o Zn
Vaccinations: 1st 24 hrs after vaccination. Related
o Influenza
o DPT
o MMR

Risk factors (recurrent)

-

1st seizure between 1-3 yoa

More than one prior febrile seizure
Risk scoring:
o One point for each
Age < 18 mo
< 1 hr between onset of fever and seizure
Fever < 104 F
1st degree relative with febrile seizures

Types:
-

Simple (MC:
o Generalized
o Duration < 15 mins
Complex
o Focal
o Duration > 15 mins

Red flags:

Meningeal signs
Altered level of consciousness

Management:
-

Lowering temp
o Antipyretics (Tylonel, Ibuprofen)
Counsel parents that recurrence is likely
Offer reassurance
o Children w/fs have normal intellectual dev
Status epilepticus: seizure > 15 mins
o ED
Benzo (Lorazedam is 1st line)
Diazepam gel @ home for PRN use