Management of Pediatric Febrile Seizures.

Daniela Laino,Elisabetta Mencaroni,Susanna Esposito

doi:10.3390/ijerph15102232

Daniela Laino, Elisabetta Mencaroni + Show 1 more

Open Access

https://doi.org/10.3390/ijerph15102232

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Abstract

Febrile seizures (FS), events associated with a fever in the absence of an intracranial infection, hypoglycaemia, or an acute electrolyte imbalance, occur in children between six months and six years of age. FS are the most common type of convulsions in children. FS can be extremely frightening for parents, even if they are generally harmless for children, making it important to address parental anxiety in the most sensitive manner. The aim of this review was to focus on the management of FS in the pediatric age. An analysis of the literature showed that most children with FS have an excellent prognosis, and few develop long-term health problems. The diagnosis of FS is clinical, and it is important to exclude intracranial infections, in particular after a complex FS. Management consists of symptom control and treating the cause of the fever. Parents and caregivers are often distressed and frightened after a FS occurs and need to be appropriately informed and guided on the management of their child’s fever by healthcare professionals. Due to the inappropriate use of diagnostic tests and treatments, it is extremely important to improve the knowledge of pediatricians and neurologists on FS management and to standardize the diagnostic and therapeutic work-up.

Highlights

Febrile seizures (FS) are seizures or convulsions that occur in children between six months and six years of and are triggered by fever [1]
Considering the frequent inappropriate prescription of diagnostic examinations and the abuse of drugs in children with FS, the aim of this review is to focus on the management of FS in the pediatric age
In children aged less than one year who present with a first episode of complex FS or have symptoms suggestive of an intracranial infection, further investigations should be considered [9], including labs such as a full blood count, C-reactive protein, urea, calcium, magnesium, glucose, and electrolyte levels, and blood cultures if bacterial sepsis is suspected; urine dipstick and culture tests; chest X-rays; stool culture tests; and a lumbar puncture

Summary

Introduction

Febrile seizures (FS) are seizures or convulsions that occur in children between six months and six years of and are triggered by fever [1]. FS are the most common type of convulsions in children. The exact causes of FS are still unknown, some studies indicate a possible association with environmental and genetic factors [4]. As demonstrated by earlier studies, the risk factors for FS are male gender, a family history of FS, an elevated peak body temperature, certain underlying causes of the fever, prenatal and natal complications, low serum calcium, sodium or blood sugar, microcytic hypochromic anemia, and iron and zinc deficiencies [6,7]. Other studies showed that FS are associated with a polygenetic inheritance, even if an autosomal dominant inheritance pattern of a defined “febrile seizure susceptibility trait” has been identified in some families. More than 3000 articles were found, but only those published in English or providing evidence-based data were included in the evaluation

Epidemiology and Clinical Features

Diagnosis

Management

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