Evaluation of a Child With a Febrile Seizure

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Clinical Practice Guideline for Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure:

Find the cause

Clinicians should identify the cause of the child's fever.

Meningitis is the biggest danger

Meningitis should be considered in the differential diagnosis for any febrile child, and lumbar puncture should be performed if there are concerns.

When to do a lumbar puncture?

For any infant between 6 and 12 months of age who presents with a seizure and fever, a lumbar puncture is an option when the child is considered deficient in Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae immunizations (ie, has not received scheduled immunizations as recommended), or when immunization status cannot be determined. This group of children is at an increased risk of bacterial meningitis.

A lumbar puncture is an option for children who are pretreated with antibiotics.

Additional tests may not be needed in a simple febrile seizure

In general, a simple febrile seizure does not usually require further evaluation, specifically electroencephalography, blood studies, or neuroimaging.

References:
Clinical Practice Guideline: Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure. PEDIATRICS Vol. 127 No. 2 February 2011, pp. 389-394 (doi:10.1542/peds.2010-3318)