Pediatric Hospital Medicine

14

Part I • Neurology

role in causing the event. 2 Table 2.7 describes the three types of febrile seizures. Data from Sawires R, Buttery J, Fahey M. A review of febrile seizures: recent advances in understanding of febrile seizure pathophysiology and commonly implicated viral triggers. Front Pediatr. 2022;9:801321. TABLE 2.6 RISK FACTORS FOR RECURRENCE OF FEBRILE SEIZURES Age < 12 mo for first febrile seizure Personal history of febrile seizures—each seizure increases the risk for recurrence. Initial seizure is a complex febrile seizure or febrile status epilepticus. Family history of febrile seizures

■ DIAGNOSTIC STUDIES See Table 2.8, based on the American Academy of Pediatrics guidelines. 1

■ MANAGEMENT A simple febrile seizure rarely requires hospitalization as most are self-limited and without sequelae. Table 2.9 reflects when to consider a hospital admission following a febrile seizure. Hospital discharge should occur when the child is at baseline and infection is managed.

TABLE 2.7 TYPES OF FEBRILE SEIZURES LENGTH

CLINICAL FEATURE RECOVERY AFTER SEIZURE

< 15 min

Simple febrile seizure

Generalized

Immediate recovery

≥ 15 min

Complex febrile seizure

• Focal • Generalized

May have some abnormali ties including an occurrence of temporary paralysis following a seizure (Todd’s paralysis)

and recurrent

• Generalized

and prolonged

> 30 min of multiple sei zures without recovery of consciousness in between 2

Febrile status epilepti cus

• Dependent on duration,

• Rarely stops

spontaneously • Often needs multiple medications, including

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• Focal or

antiepileptics and benzodiazepines 3

generalized

Data from Mewasingh LD, Chin RFM, Scott RC. Current understanding of febrile seizures and their long-term outcomes. Dev Med Child Neurol. 2020;62(11):1245-1249.