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Febrile seizures
Shlomo Shinnar1, Tracy A Glauser
1Montefiore Medical Center, and the Albert Einstein College of Medicine, Bronx, NY 10467, USA. sshinnar@aol.com
Insights
Febrile seizures are common in children and usually benign. While recurrence is possible, most children do not develop epilepsy, and treatment focuses on managing seizures rather than preventing future epilepsy.
Area of Science:
- Neurology
- Pediatrics
Background:
- Febrile seizures are the most common seizure type in children, affecting 2-5% in the US.
- Seizures are classified as simple or complex based on characteristics like duration and focal onset.
- Risk factors for febrile seizures, recurrence, and epilepsy development are varied.
Purpose of the Study:
- To review the current understanding of prognosis and management of febrile seizures.
- To discuss the changing approach to treating febrile seizures.
Main Methods:
- Review of current literature on febrile seizures.
- Analysis of risk factors, recurrence, and long-term outcomes.
- Evaluation of treatment strategies, including antiepileptic drugs.
Main Results:
- Febrile seizures generally have a good prognosis with minimal risk of mortality or morbidity.
- Most children with febrile seizures do not develop epilepsy.
- Antiepileptic drugs can prevent recurrence but do not impact the risk of developing epilepsy.
Conclusions:
- Febrile seizures are largely benign neurological events in childhood.
- Management strategies are evolving, focusing on the benign nature and low risk of epilepsy.
- Treatment decisions should consider the limited impact of antiepileptic drugs on long-term epilepsy risk.
Abstract:
Febrile seizures are the most common form of childhood seizures, occurring in 2 to 5% of children in the United States. Most febrile seizures are considered simple, although those with focal onset, prolonged duration, or that occur more than once within the same febrile illness are considered complex. Risk factors for a first febrile seizure, recurrence of febrile seizures, and development of future epilepsy are identifiable and varied. Children with febrile seizures encounter little risk of mortality and morbidity and have no association with any detectable brain damage. Recurrence is possible, but only a small minority will go on to develop epilepsy. Although antiepileptic drugs can prevent recurrent febrile seizures, they do not alter the risk of subsequent epilepsy. This has led to a changing view of how we approach the treatment of these common and largely benign seizures. This chapter will review the current understanding of the prognosis and management of febrile seizures.