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Seizures, Febrile

Swati Avashia, MD, FAAP, FACP, ABIHM and Stephen W. Line, DO Reviewed 06/2020
 


BASICS

DESCRIPTION

Febrile seizures occur in children ages 6 months to 5 years with fever ≥100.4°F (38°C) and absence of underlying neurologic abnormality, metabolic condition, or intracranial infectio...

DIAGNOSIS

HISTORY

  • History of present illness:

    • Description and duration of seizure:

      • Febrile seizures are generalized with clonic or tonic–clonic activity

      • Absence, myoclonic, atonic, and focal seizures are ...

TREATMENT

Most seizures are self-limited and end before EMS arrives or the child arrives at the hospital. 

GENERAL MEASURES

  • Acute seizure management (1)

    • Airway: Position the patient laterally, suction se...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Anticonvulsant prophylaxis during subsequent febrile episodes:

    • American Academy of Pediatrics recommends against prophylaxis with anticonvulsants due to an unaccep...

REFERENCES

1
Smith DK, Sadler KP, Benedum M. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician.  2019;99(7):445–450.
2
Whelan H, Harmelink M, Chou E, et al. Complex febrile seizur...

ADDITIONAL READING

  • McTague A, Martland T, Appleton R. Drug management for acute tonicclonic convulsions including convulsive status epilepticus in children. Cochrane Database Syst Rev.  2018;(1):...

CODES

ICD10

  • R56.00 Simple febrile convulsions

  • R56.01 Complex febrile convulsions

  • G40.901 Epilepsy, unsp, not intractable, with status epilepticus

ICD9

  • 780.31 Febrile convulsions (simple), unspecified

  • 780.32...

CLINICAL PEARLS

  • Febrile seizures are generally benign and without sequelae.

  • Evaluate for for underlying causes such as meningitis, trauma, or other intracranial pathology.

  • For SFS, routine labs, lumbar ...

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