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Updated: May 3, 2026

A Behavioral Screen for Heat-Induced Seizures in Mouse Models of Epilepsy
Published on: July 12, 2021
Febrile seizures
1Imperial College Healthcare NHS Trust, London, UK.
Insights
This review examines treatments for simple febrile seizures in children. Intermittent anticonvulsants, antipyretics, and conservative measures were evaluated for effectiveness and safety.
Area of Science:
- Pediatrics
- Neurology
- Clinical Pharmacology
Background:
- Simple febrile seizures are common, generalized seizures lasting under 10-15 minutes, occurring once every 24 hours.
- They affect 2-9% of children globally by age 5 and do not cause permanent neurological deficits.
- Complex febrile seizures differ in duration, symptoms, and recurrence patterns.
Purpose of the Study:
- To systematically review the effects of treatments administered during fever episodes in children aged 6 months to 5 years with a history of simple febrile seizures.
- To evaluate the effectiveness and safety of various interventions.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) and systematic reviews of RCTs was conducted.
- Searches included major databases (Medline, Embase, Cochrane Library) up to July 2013.
- Harms alerts from regulatory agencies (FDA, MHRA) were also incorporated.
Main Results:
- Four RCTs or systematic reviews of RCTs met the inclusion criteria.
- A GRADE evaluation was performed to assess the quality of evidence for interventions.
- The review identified studies on intermittent anticonvulsants, antipyretics, and conservative measures.
Conclusions:
- The review presents findings on the effectiveness and safety of intermittent anticonvulsants (clobazam, diazepam, lorazepam).
- Antipyretic drug treatments (paracetamol, ibuprofen) were also evaluated.
- Conservative measures, including watchful waiting and physical cooling techniques, were assessed.
Introduction:
Simple febrile seizures are generalised in onset and have a brief duration. The American Academy of Pediatrics defines this brief duration to be <15 minutes; whereas, in the UK, a maximum duration of 10 minutes is used. Simple febrile seizures do not occur more than once in 24 hours and resolve spontaneously. Complex febrile seizures are longer lasting, have focal symptoms (at onset or during the seizure), and can recur within 24 hours or within the same febrile illness. This review only deals with simple febrile seizures. About 2% to 5% of children in the US and Western Europe, and 6% to 9% of infants and children in Japan, will have experienced at least one febrile seizure by the age of 5 years. A very small number of children with simple febrile seizures may develop afebrile seizures, but simple febrile seizures are not associated with any permanent neurological deficits.
Methods And Outcomes:
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments given during episodes of fever in children (aged 6 months to 5 years) with one or more previous simple febrile seizures? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2013 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
Results:
We found 4 RCTs or systematic reviews of RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
Conclusions:
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: intermittent anticonvulsants (clobazam, diazepam, lorazepam), antipyretic drug treatments (paracetamol, ibuprofen), and conservative measures (watchful waiting, physical antipyretic measures [tepid sponging, removing clothes, cooling room, direct fanning of child]).
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