A synopsis of the American Academy of Pediatrics' practice parameters on the evaluation and treatment of children with febrile seizures.

Abstract

1. Patricia K. Duffner, MD* 2. Robert J. Baumann† 1. 2. *Professor of Neurology and Pediatrics, Division of Child Neurology, Childrens’ Hospital of Buffalo, State University of New York, Buffalo, NY. 3. 4. †Professor of Neurology, Department of Neurology, University of Kentucky, Lexington, KY. This article provides a summary of the practice parameters on febrile seizures. The reader is urged to read the original parameters and technical reports in their entirety for a more complete understanding of the conceptual basis for the recommendations .1,2(1)(2) Febrile seizures are the most common convulsive event in childhood, occurring in 2% to 5% of children younger than 5 years of age. Despite their frequency, there have been longstanding differences among pediatricians, family practitioners, child neurologists, and emergency physicians regarding both the neurodiagnostic evaluation of the child who has a simple febrile seizure and the appropriate approach to long-term therapy. The American Academy of Pediatrics (AAP) and its Provisional Committee on Quality Improvement, in collaboration with experts from the Section of Neurology, general pediatricians, pediatric epileptologists, and epidemiologists, developed two practice parameters for children who have febrile seizures. The first was published in 1996,1(1) and the second was published in 1999.2(2) The parameters were restricted to children who were neurologically normal between the ages of 6 months and 5 years and who experienced simple febrile seizures. A simple febrile seizure was defined as a brief (<15 min) generalized seizure that occurred only once in a 24-hour period in a febrile child who did not have an intracranial infection. Recommendations regarding children who had complex febrile seizures were deferred. The Committee that wrote the first parameter, “The Neurodiagnostic Evaluation of the Child With a First Simple Febrile Seizure”, consisted of a practicing pediatrician, three child neurologists (one of whom is a neuroepidemiologist), and the chair, who is a pediatric cardiologist (see Appendix). The second parameter,“ The Long-Term Treatment of the Child With Simple Febrile Seizures”, was developed by the same group, with the following changes: one child neurologist was added, and the chair from …