Abstract
Febrile seizures are one of the commonest presentations in young children, with a 2–5% incidence in Western countries. Though they are generally benign, with rare long-term sequelae, there is much to be learned about their pathophysiology and risk factors. Febrile seizures are propagated by a variety of genetic and environmental factors, including viruses and vaccines. These factors must be taken into consideration by a clinician aiming to assess, diagnose and treat a child presenting with fevers and seizures, as well as to explain the sequelae of the febrile seizures to the concerned parents of the child. Our article provides an overview of this common childhood condition, outlining both the underlying mechanisms and the appropriate clinical approach to a child presenting with febrile seizures.
Highlights
Febrile seizures are the most common seizure of childhood [1]. They are seizure events occurring in young febrile children, where the fever is not due to infection of the central nervous system (CNS) [1]
This article will provide an overview of febrile seizure epidemiology and risk factors, clinical presentations, and current management, as well as triggers commonly implicated in febrile seizures
Children with previous afebrile seizures are excluded from the group of children with febrile seizures as the febrile illness is perceived as a trigger of a pre-existing predisposition to epilepsy [5]
Summary
Febrile seizures are classified as either simple or complex based on their clinical features. Some environmental risk factors have been associated with increased febrile seizure incidence, including maternal smoking and stress [5, 20]. Some vaccinations both pose an increased chance of febrile seizure incidence in a short period of time following vaccination, they prevent infection by common viruses which cause febrile seizures and reduce the risk overall. These associations underline the importance of viral infections in febrile seizures. Studies have shown more frequent genetic mutations in IL-1α and IL-1β genes in patients with temporal lobe epilepsy, and IL-1β in patients with febrile seizures compared with healthy controls [68, 69]. One randomised control study in Japan has shown that rectal acetaminophen may reduce the risk of febrile seizure recurrence within the same febrile episode [76]
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