"Simple febrile seizures plus (SFS+)": more than one febrile seizure within 24 hours is usually okay

Area of Science:

• Pediatric Neurology
• Epileptology

Background:

• Febrile seizures are common in young children.
• Distinguishing between simple and complex febrile seizures is crucial for management.
• Recurrent febrile seizures within 24 hours (febrile seizure clusters) warrant further investigation.

Purpose of the Study:

• To determine if children experiencing recurrent febrile seizures within 24 hours require a different diagnostic workup compared to those with simple febrile seizures.
• To evaluate the neuroimaging and EEG findings in children with febrile seizure clusters.

Main Methods:

• A retrospective study of 32 children aged 4 months to 3 years with their first seizure cluster within 24 hours.
• All patients underwent brain CT/MRI and EEG.
• Inclusion criteria specified recurrent seizures within 24 hours with return to baseline between events.

Main Results:

• All head CT scans were normal.
• Two MRI scans showed benign abnormalities: postictal changes and an incidental arachnoid cyst.
• Four EEGs were abnormal, with one showing epileptiform discharges and others showing generalized ictal/postictal features.

Conclusions:

• Children with recurrent febrile seizures within 24 hours, who otherwise present similarly to simple febrile seizures, may not need a different workup.
• The proposed term 'simple febrile seizures plus (SFS+)' can describe these cases.
• Benign findings are common in neuroimaging and EEG for this group.