Febrile seizures - 2012 review from Am Fam Physician

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From Am Fam Physician:

Febrile seizures are common in the first 5 years of life.

Initial evaluation should determine whether features of a complex seizure are present and identify the source of fever.

Routine blood tests, neuroimaging, and electroencephalography are not recommended.

Lumbar puncture is no longer recommended in patients with uncomplicated febrile seizures.

In the unusual case of febrile status epilepticus, intravenous lorazepam and buccal midazolam are first-line agents.

After an initial febrile seizure, physicians should reassure parents about the low risk of long-term effects. However, there is a 15-70% risk of recurrence in the first 2 years after an initial febrile seizure.

This risk is increased in patients:

- younger than 18 months
- with a lower fever
- short duration of fever before seizure onset
- family history of febrile seizures

Antiepileptic or antipyretic medications are not recommended for the prevention of recurrent febrile seizures.

References:

Febrile seizures: risks, evaluation, and prognosis. Graves RC, Oehler K, Tingle LE. Am Fam Physician. 2012 Jan 15;85(2):149-53.

http://www.ncbi.nlm.nih.gov/pubmed/22335215?dopt=Abstract