Show Notes
Background
The most common type of seizure in children under 5 years of age
Occur in 2-5% of children
In children with a fever, aged 6 months to 5 years of age, and without a CNS infection
Risk Factors
4 times more likely to have a febrile seizure if parent had one
Also increase in risk if siblings or nieces / nephews had one
Common associated infections
Human Herpesvirus 6
Human Herpesvirus 7
Influenza A & B
Simple Febrile Seizure
Generalized tonic-clonic activity lasting less than 15 minutes in a child 6 months to 5 years of age
Complex Febrile Seizure
Lasts longer than 15 minutes, occurs in a child outside of this age range, are focal, or that recur within a 24-hour period.
Diagnostics / Workup
Gather thorough history and perform thorough physical exam
Most cases will not require labs, imaging or EEG
If e/o meningitis, perform LP
AAP suggests considering LP in:
Children 6-12 months who are not immunized for H flu type B or strep pneumo
Children who had been on antibiotics
For complex seizures, clinician may have a lower threshold for obtaining labs
Hyponatremia is more common in this group than in the general population.
LPs are more commonly done by providers, but these are low yield with one study showing bacterial meningitis being diagnosed in just 0.9% (Kimia 2010), all of whom did not have a normal exam or negative cultures.
Neuroimaging is also exceedingly low yield if the patient re...