[Complex febrile crises: should we change the way we act?]

Area of Science:

• Neurology
• Pediatrics
• Clinical Medicine

Background:

• Febrile seizures are a common reason for pediatric healthcare visits.
• Historically, complex febrile seizures (CFS) necessitated hospitalization due to perceived risks of epilepsy and complications.
• Emerging evidence suggests a less invasive management approach for CFS is feasible.

Purpose of the Study:

• To characterize patients hospitalized for CFS.
• To propose an updated protocol for managing CFS cases.

Main Methods:

• Retrospective analysis of medical records for hospitalized CFS patients (Jan 2010-Dec 2013).
• Collection and presentation of epidemiological, clinical, and follow-up data.
• Evaluation of the diagnostic utility of complementary tests during the acute phase.

Main Results:

• CFS represented 4.2% of pediatric neurology admissions (67 patients).
• Mean age was 25 months; 47% had a family history, and 31% had prior febrile seizures.
• Most CFS events were brief (<5 min) and recurrent, often within the first day. Diagnostic tests were not useful acutely. Five patients had complications during follow-up. Family history correlated with higher epilepsy/recurrence risk (p=0.02).

Conclusions:

• CFS are not linked to increased acute complications.
• Current complementary examinations do not reliably identify high-risk patients early.
• Hospitalization for CFS could be avoided in most cases, reserving it for those with additional clinical signs.