Moving on, let’s keep things “simple” lest we risk making them too “complex.”
What makes a febrile seizure simple?
- 6 months to 5 years of age
- Generalized (no focal findings)
- Less than 15 minutes
- Single episode
- Neurologically normal child on exam/history with normal development on history
- Fever (and seizure) is not caused by meningitis, encephalitis, or other CNS illness/process
- Focal findings
- Longer than 15 minutes
- Multiple episodes / more than one in 24 hours
- Longer than 30 minutes
All febrile seizures are proceeded by fever right?
The majority of children have their most have their seizure on the first day of illness. It can also be the first manifestation of illness (which must be terrifying for parents). 1/4 patients have fever between 38-39 C, and therefore the height of fever doesn’t correlate with the occurrence of seizures. The degree of fever associated with febrile convulsions is variable, and approximately 25 percent of events occur when the temperature is between 38ºC and 39ºC. They can occur when the temp is rapidly rising, but not always.