Febrile Seizures

This article provides an update on the current understanding and management of febrile seizures. Febrile seizures are one of the most common age-related epileptic convulsions that lead to outpatient consultations, emergency department visits, and hospital or intensive care admissions.

The Consequences of Prolonged Febrile Seizures in Childhood (FEBSTAT) study, an ongoing multicenter prospective longitudinal study, is providing valuable insights into the subset of patients who develop febrile status epilepticus, the most life-threatening type of febrile seizures with potential long-term consequences. Mutations in voltage-gated ion channels and neurotransmitter receptor genes have been shown to result in familial occurrence of febrile seizures and epilepsy. Acute abortive treatment of febrile seizures using a commercially available rectal delivery kit has gained widespread use by nonmedical caregivers as a first-line treatment at home.

Most febrile seizures are self-limiting episodes with low risk of injury, death, and long-term neurologic consequences. Most fevers and infections that cause febrile seizures are relatively benign and do not require extensive testing or procedures. Long-term management requires thorough assessment and risk stratification to devise a customized plan for each child, paying attention to the caregiver situation at home and day care. Most important treatment efforts are directed at caregiver education and, when appropriate, on effective use of abortive seizure treatment at home.