Category: Pediatrics
Keywords: pediatrics, fever, seizure (PubMed Search)
Posted: 1/9/2025 by Kathleen Stephanos, MD
(Updated: 3/14/2025)
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Simple Febrile Seizures are a very common cause for presentation to the Emergency Department.
Up to 5% of children will have one in their lifetime, and a single febrile seizure increases risk of recurrence.
Definition:
While not part of the formal definition, the following details are critical to obtain on history, and high risk features that should not be missed on initial evaluation:
Evaluation and Management:
Consider a finger stick
Most patients can be discharged to home after a period of observation - most use a 2-4 hour minimum. More recent literature suggests considering a longer observation period in patients who have seizures at lower core body temperatures (<39°C) or those with a history of recurrent simple febrile seizures (2 simple febrile seizures within 24 hours with return to baseline in between)
Obtain a lumbar puncture in all patients with symptoms of meningitis
Consider a lumbar puncture, lab evaluation, and prolonged observation in patients who are under-vaccinated/unvaccinated/unknown vaccination status between 6 months and 12 months of age, or received antibiotics within the last 48 hours
Eilbert W, Chan C. Febrile seizures: A review. J Am Coll Emerg Physicians Open. 2022 Aug 23;3(4):e12769. doi: 10.1002/emp2.12769. PMID: 36016968; PMCID: PMC9396974.
