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Open Access 01-12-2024 | Febrile Seizure | Review

Best practices for the management of febrile seizures in children

Authors: Alessandro Ferretti, Antonella Riva, Alice Fabrizio, Oliviero Bruni, Giuseppe Capovilla, Thomas Foiadelli, Alessandro Orsini, Umberto Raucci, Antonino Romeo, Pasquale Striano, Pasquale Parisi

Published in: Italian Journal of Pediatrics | Issue 1/2024

Abstract

Febrile seizures (FS) are commonly perceived by healthcare professionals as a self-limited condition with a generally ‘benign’ nature. Nonetheless, they frequently lead to pediatric consultations, and their management can vary depending on the clinical context. For parents and caregivers, witnessing a seizure can be a distressing experience, significantly impacting their quality of life. In this review, we offer an in-depth exploration of FS management, therapeutic interventions, and prognostic factors, with the aim of providing support for physicians and enhancing communication with families. We conducted a comprehensive literature search using the PubMed and Web of Science databases, spanning the past 50 years. The search terms utilized included “febrile seizure,” “complex febrile seizure,” “simple febrile seizure,” in conjunction with “children” or “infant.” Only studies published in English or those presenting evidence-based data were included in our assessment. Additionally, we conducted a cross-reference search to identify any additional relevant data sources. Our thorough literature search resulted in a compilation of references, with carefully selected papers thoughtfully integrated into this review.

Hampers LC, Trainor JL, Listernick R, Eddy JJ, Thompson DA, Sloan EP, et al. Setting-based practice variation in the management of simple febrile seizure. Acad Emerg Med. 2000;7(1):21–7. https://doi.org/10.1111/j.1553-2712.2000.tb01886.x.CrossRefPubMed

Jones T, Jacobsen SJ. Childhood febrile seizures: overview and implications. Int J Med Sci. 2007;4(2):110–4. https://doi.org/10.7150/ijms.4.110.CrossRefPubMedPubMedCentral

Practice parameter. Long-term treatment of the child with simple febrile seizures. American Academy of Pediatrics. Committee on Quality Improvement, Subcommittee on Febrile seizures. Pediatrics. 1999;103(6 Pt 1):1307–9. https://doi.org/10.1542/peds.103.6.1307.CrossRef

Subcommittee on Febrile Seizures; American Academy of Pediatrics. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011;127(2):389–94. https://doi.org/10.1542/peds.2010-3318.CrossRef

Sartori S, Nosadini M, Tessarin G, Boniver C, Frigo AC, Toldo I, et al. First-ever convulsive seizures in children presenting to the emergency department: risk factors for seizure recurrence and diagnosis of epilepsy. Dev Med Child Neurol. 2019;61(1):82–90. https://doi.org/10.1111/dmcn.14015.CrossRefPubMed

Pavone P, Corsello G, Ruggieri M, Marino S, Marino S, Falsaperla R. Benign and severe early-life seizures: a round in the first year of life. Ital J Pediatr. 2018;44(1):54. https://doi.org/10.1186/s13052-018-0491-z.CrossRefPubMedPubMedCentral

Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia. 1994;35(Suppl 2):1–6. https://doi.org/10.1111/j.1528-1157.1994.tb05932.x.CrossRef

Verity CM, Butler NR, Golding J. Febrile convulsions in a national cohort followed up from birth. I–Prevalence and recurrence in the first five years of life. Br Med J (Clin Res Ed). 1985;290(6478):1307–10. https://doi.org/10.1136/bmj.290.6478.1307.CrossRefPubMed

Tsuboi T. Epidemiology of febrile and afebrile convulsions in children in Japan. Neurology. 1984;34(2):175–81. https://doi.org/10.1212/wnl.34.2.175.CrossRefPubMed

10.

Bethune P, Gordon K, Dooley J, Camfield C, Camfield P. Which child will have a febrile seizure? Am J Dis Child. 1993;147(1):35–9. https://doi.org/10.1001/archpedi.1993.02160250037013.CrossRefPubMed

11.

Annegers JF, Hauser WA, Anderson VE, Kurland LT. The risks of seizure disorders among relatives of patients with childhood onset epilepsy. Neurology. 1982;32(2):174–9. https://doi.org/10.1212/wnl.32.2.174.CrossRefPubMed

12.

Tsuboi T, Endo S. Genetic studies of febrile convulsions: analysis of twin and family data. Epilepsy Res Suppl. 1991;4:119–28.PubMed

13.

van Esch A, Steyerberg EW, van Duijn CM, Offringa M, Derksen-Lubsen G, van Steensel-Moll HA. Prediction of febrile seizures in siblings: a practical approach. Eur J Pediatr. 1998;157(4):340–4. https://doi.org/10.1007/s004310050824.CrossRefPubMed

14.

Berkovic SF, Scheffer IE. Febrile seizures: genetics and relationship to other epilepsy syndromes. Curr Opin Neurol. 1998;11(2):129–34. https://doi.org/10.1097/00019052-199804000-00009.CrossRefPubMed

15.

Baulac S, Gourfinkel-An I, Picard F, Rosenberg-Bourgin M, Prud’homme JF, Baulac M, et al. A second locus for familial generalized epilepsy with febrile seizures plus maps to chromosome 2q21-q33. Am J Hum Genet. 1999;65(4):1078–85. https://doi.org/10.1086/302593.CrossRefPubMedPubMedCentral

16.

Nakayama J, Hamano K, Iwasaki N, Nakahara S, Horigome Y, Saitoh H, et al. Significant evidence for linkage of febrile seizures to chromosome 5q14-q15. Hum Mol Genet. 2000;9(1):87–91. https://doi.org/10.1093/hmg/9.1.87.CrossRefPubMed

17.

Wallace RH, Berkovic SF, Howell RA, Sutherland GR, Mulley JC. Suggestion of a major gene for familial febrile convulsions mapping to 8q13-21. J Med Genet. 1996;33(4):308–12. https://doi.org/10.1136/jmg.33.4.308.CrossRefPubMedPubMedCentral

18.

Johnson EW, Dubovsky J, Rich SS, O’Donovan CA, Orr HT, Anderson VE, et al. Evidence for a novel gene for familial febrile convulsions, FEB2, linked to chromosome 19p in an extended family from the Midwest. Hum Mol Genet. 1998;7(1):63–7. https://doi.org/10.1093/hmg/7.1.63.CrossRefPubMed

19.

Wallace RH, Wang DW, Singh R, Scheffer IE, George AL Jr, Phillips HA, et al. Febrile seizures and generalized epilepsy associated with a mutation in the Na+-channel beta1 subunit gene SCN1B. Nat Genet. 1998;19(4):366–70. https://doi.org/10.1038/1252.CrossRefPubMed

20.

Myers KA, Scheffer IE, Berkovic SF, ILAE Genetics Commission. Genetic literacy series: genetic epilepsy with febrile seizures plus. Epileptic Disord. 2018;20(4):232–8. https://doi.org/10.1684/epd.2018.0985.CrossRefPubMed

21.

Carman KB, Calik M, Karal Y, Isikay S, Kocak O, Ozcelik A, et al. Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study). Hum Vaccin Immunother. 2019;15(2):496–502. https://doi.org/10.1080/21645515.2018.1526588.CrossRefPubMed

22.

Chung B, Wong V. Relationship between five common viruses and febrile seizure in children. Arch Dis Child. 2007;92(7):589–93. https://doi.org/10.1136/adc.2006.110221.CrossRefPubMedPubMedCentral

23.

Hall CB, Long CE, Schnabel KC, Caserta MT, McIntyre KM, Costanzo MA, et al. Human herpesvirus-6 infection in children. A prospective study of complications and reactivation. N Engl J Med. 1994;331(7):432–8. https://doi.org/10.1056/NEJM199408183310703.CrossRefPubMed

24.

Fang C, Zhou Y, Fan W, Zhang C, Yang Y. Clinical features of febrile seizures in children with COVID-19: an observational study from a tertiary care hospital in China. Front Pediatr. 2023;11:1290806. https://doi.org/10.3389/fped.2023.1290806.CrossRefPubMedPubMedCentral

25.

Pavone P, Pappalardo XG, Parano E, Falsaperla R, Marino SD, Fink JK, et al. Fever-Associated seizures or Epilepsy: an overview of Old and recent literature acquisitions. Front Pediatr. 2022;10:858945. https://doi.org/10.3389/fped.2022.858945.CrossRefPubMedPubMedCentral

26.

Costagliola G, Depietri G, Michev A, Riva A, Foiadelli T, Savasta S, et al. Targeting Inflammatory mediators in Epilepsy: a systematic review of its molecular basis and clinical applications. Front Neurol. 2022;13:741244. https://doi.org/10.3389/fneur.2022.741244.CrossRefPubMedPubMedCentral

27.

Orsini A, Foiadelli T, Costagliola G, Michev A, Consolini R, Vinci F, et al. The role of inflammatory mediators in epilepsy: focus on developmental and epileptic encephalopathies and therapeutic implications. Epilepsy Res. 2021;172:106588. https://doi.org/10.1016/j.eplepsyres.2021.106588.CrossRefPubMed

28.

Shinnar S, Glauser TA. Febrile seizures. J Child Neurol. 2002;17(Suppl 1):S44–52. https://doi.org/10.1177/08830738020170010601.CrossRefPubMed

29.

Berg AT, Shinnar S, Shapiro ED, Salomon ME, Crain EF, Hauser WA. Risk factors for a first febrile seizure: a matched case-control study. Epilepsia. 1995;36(4):334–41. https://doi.org/10.1111/j.1528-1157.1995.tb01006.x.CrossRefPubMed

30.

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. https://doi.org/10.3389/fped.2021.801321.CrossRefPubMedPubMedCentral

31.

Minchom PE, Wallace SJ. Febrile convulsions: electroencephalographic changes related to rectal temperature. Arch Dis Child. 1984;59(4):371–3. https://doi.org/10.1136/adc.59.4.371.CrossRefPubMedPubMedCentral

32.

Berg AT. Are febrile seizures provoked by a rapid rise in temperature? Am J Dis Child. 1993;147(10):1101–3. https://doi.org/10.1001/archpedi.1993.02160340087020.CrossRefPubMed

33.

Mancardi MM, Striano PP, Gennaro E, Madia F, Paravidino R, Scapolan S, et al. Familial occurrence of febrile seizures and epilepsy in severe myoclonic epilepsy of infancy (SMEI) patients with SCN1A mutations. Epilepsia. 2006;47(10):1629–35. https://doi.org/10.1111/j.1528-1167.2006.00641.x.CrossRefPubMed

34.

Kolc KL, Sadleir LG, Scheffer IE, Ivancevic A, Roberts R, Pham DH, et al. A systematic review and meta-analysis of 271 PCDH19-variant individuals identifies psychiatric comorbidities, and association of seizure onset and disease severity. Mol Psychiatry. 2019;24(2):241–51. https://doi.org/10.1038/s41380-018-0066-9.CrossRefPubMed

35.

Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child. 2004;89(8):751–6. https://doi.org/10.1136/adc.2003.028449.CrossRefPubMedPubMedCentral

36.

Eilbert W, Chan C. Febrile seizures: a review. J Am Coll Emerg Physicians Open. 2022;3(4):e12769. https://doi.org/10.1002/emp2.12769.CrossRefPubMedPubMedCentral

37.

Verity CM, Golding J. Risk of epilepsy after febrile convulsions: a national cohort study. BMJ. 1991;303(6814):1373–6. https://doi.org/10.1136/bmj.303.6814.1373.CrossRefPubMedPubMedCentral

38.

Francis JR, Richmond P, Robins C, Lindsay K, Levy A, Effler PV, et al. An observational study of febrile seizures: the importance of viral infection and immunization. BMC Pediatr. 2016;16(1):202. https://doi.org/10.1186/s12887-016-0740-5.CrossRefPubMedPubMedCentral

39.

Vitaliti G, Castagno E, Ricceri F, Urbino A, Di Pianella AV, Lubrano R, et al. Epidemiology and diagnostic and therapeutic management of febrile seizures in the Italian pediatric emergency departments: a prospective observational study. Epilepsy Res. 2017;129:79–85. https://doi.org/10.1016/j.eplepsyres.2016.11.005.CrossRefPubMed

40.

Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis, International League against Epilepsy. Epilepsia. 1993;34(4):592–6. https://doi.org/10.1111/j.1528-1157.1993.tb00433.x.CrossRef

41.

Zerbo O, Modaressi S, Goddard K, Lewis E, Fireman B, Daley MF, et al. Safety of measles and pertussis-containing vaccines in children with autism spectrum disorders. Vaccine. 2022;40(18):2568–73. https://doi.org/10.1016/j.vaccine.2022.03.031.CrossRefPubMedPubMedCentral

42.

Maytal J, Shinnar S. Febrile status epilepticus. Pediatrics. 1990;86(4):611–6.CrossRefPubMed

43.

DeLorenzo RJ, Hauser WA, Towne AR, Boggs JG, Pellock JM, Penberthy L, et al. A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology. 1996;46(4):1029–35. https://doi.org/10.1212/wnl.46.4.1029.CrossRefPubMed

44.

Chin RF, Neville BG, Peckham C, Bedford H, Wade A, Scott RC, et al. Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. Lancet. 2006;368(9531):222–9. https://doi.org/10.1016/S0140-6736(06)69043-0.CrossRefPubMed

45.

Hesdorffer DC, Shinnar S, Lewis DV, Moshé SL, Nordli DR Jr, Pellock JM, et al. Design and phenomenology of the FEBSTAT study. Epilepsia. 2012;53(9):1471–80. https://doi.org/10.1111/j.1528-1167.2012.03567.x.CrossRefPubMedPubMedCentral

46.

Agarwal M, Fox SM. Pediatric seizures. Emerg Med Clin North Am. 2013;31(3):733–54. https://doi.org/10.1016/j.emc.2013.04.001.CrossRefPubMed

47.

Glauser T, Shinnar S, Gloss D, Alldredge B, Arya R, Bainbridge J, et al. Evidence-based Guideline: treatment of Convulsive Status Epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr. 2016;16(1):48–61. https://doi.org/10.5698/1535-7597-16.1.48.CrossRefPubMedPubMedCentral

48.

McTague A, Martland T, Appleton R. Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children. Cochrane Database Syst Rev. 2018;1(1):CD001905. https://doi.org/10.1002/14651858.CD001905.pub3.CrossRefPubMed

49.

Stewart WA, Harrison R, Dooley JM. Respiratory depression in the acute management of seizures. Arch Dis Child. 2002;87(3):225–6. https://doi.org/10.1136/adc.87.3.225.CrossRefPubMedPubMedCentral

50.

Lawton B, Davis T, Goldstein H, Tagg A. An update in the initial management of paediatric status epilepticus. Curr Opin Pediatr. 2018;30(3):359–63. https://doi.org/10.1097/MOP.0000000000000616.CrossRefPubMed

51.

Becker LL, Gratopp A, Prager C, Elger CE, Kaindl AM. Treatment of pediatric convulsive status epilepticus. Front Neurol. 2023;14:1175370. https://doi.org/10.3389/fneur.2023.1175370.CrossRefPubMedPubMedCentral

52.

Camfield P, Camfield C. Febrile seizures and genetic epilepsy with febrile seizures plus (GEFS+). Epileptic Disord. 2015;17(2):124–33. https://doi.org/10.1684/epd.2015.0737.CrossRefPubMed

53.

Guedj R, Chappuy H, Titomanlio L, Trieu TV, Biscardi S, Nissack-Obiketeki G, et al. Risk of bacterial meningitis in children 6 to 11 months of Age with a first simple febrile seizure: a Retrospective, cross-sectional, observational study. Acad Emerg Med. 2015;22(11):1290–7. https://doi.org/10.1111/acem.12798.CrossRefPubMed

54.

Anand A, Salas A, Mahl E, Levine MC. Cerebral abscess presenting as a Complex Febrile Seizure. Pediatr Emerg Care. 2015;31(7):499–502. https://doi.org/10.1097/PEC.0000000000000281.CrossRefPubMed

55.

Kimia A, Ben-Joseph EP, Rudloe T, Capraro A, Sarco D, Hummel D, et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics. 2010;126(1):62–9. https://doi.org/10.1542/peds.2009-2741.CrossRefPubMed

56.

Guedj R, Chappuy H, Titomanlio L, De Pontual L, Biscardi S, Nissack-Obiketeki G, et al. Do all children who Present with a Complex Febrile Seizure need a lumbar puncture? Ann Emerg Med. 2017;70(1):52–e626. https://doi.org/10.1016/j.annemergmed.2016.11.024.CrossRefPubMed

57.

Eldardear A, Alhejaili FAD, Alharbi AMD, Alrehaili FSS, Mohammed KTA, Binladin AKA, et al. Incidence of Meningitis in patients presenting with febrile seizures. Cureus. 2020;12(12):e11941. https://doi.org/10.7759/cureus.11941.CrossRefPubMedPubMedCentral

58.

Boyle DA, Sturm JJ. Clinical factors associated with invasive testing and imaging in patients with complex febrile seizures. Pediatr Emerg Care. 2013;29(4):430–4. https://doi.org/10.1097/PEC.0b013e318289e8f1.CrossRefPubMed

59.

Kimia AA, Ben-Joseph E, Prabhu S, Rudloe T, Capraro A, Sarco D, et al. Yield of emergent neuroimaging among children presenting with a first complex febrile seizure. Pediatr Emerg Care. 2012;28(4):316–21. https://doi.org/10.1097/PEC.0b013e31824d8b0b.CrossRefPubMed

60.

Teng D, Dayan P, Tyler S, Hauser WA, Chan S, Leary L, et al. Risk of intracranial pathologic conditions requiring emergency intervention after a first complex febrile seizure episode among children. Pediatrics. 2006;117(2):304–8. https://doi.org/10.1542/peds.2005-0759.CrossRefPubMed

61.

Eeg-Olofsson O, Petersén I, Selldén U. The development of the electroencephalogram in normal children from the age of 1 through 15 years. Paroxysmal activity. Neuropadiatrie. 1971;2(4):375–404. https://doi.org/10.1055/s-0028-1091791.CrossRefPubMed

62.

Harini C, Nagarajan E, Kimia AA, de Carvalho RM, An S, Bergin AM, et al. Utility of initial EEG in first complex febrile seizure. Epilepsy Behav. 2015;52(Pt A):200–4. https://doi.org/10.1016/j.yebeh.2015.09.003.CrossRefPubMed

63.

Wo SB, Lee JH, Lee YJ, Sung TJ, Lee KH, Kim SK. Risk for developing epilepsy and epileptiform discharges on EEG in patients with febrile seizures. Brain Dev. 2013;35(4):307–11. https://doi.org/10.1016/j.braindev.2012.07.014.CrossRefPubMed

64.

Kanemura H, Mizorogi S, Aoyagi K, Sugita K, Aihara M. EEG characteristics predict subsequent epilepsy in children with febrile seizure. Brain Dev. 2012;34(4):302–7. https://doi.org/10.1016/j.braindev.2011.07.007.CrossRefPubMed

65.

Shah PB, James S, Elayaraja S. EEG for children with complex febrile seizures. Cochrane Database Syst Rev. 2017;10(10):CD009196. https://doi.org/10.1002/14651858.CD009196.pub4.CrossRefPubMed

66.

Knudsen FU. Febrile seizures: treatment and prognosis. Epilepsia. 2000;41(1):2–9. https://doi.org/10.1111/j.1528-1157.2000.tb01497.x.CrossRefPubMed

67.

Kim YS, Jung KH, Lee ST, Kang BS, Yeom JS, Moon J, et al. Prognostic Value of Initial Standard EEG and MRI in patients with Herpes Simplex Encephalitis. J Clin Neurol. 2016;12(2):224–9. https://doi.org/10.3988/jcn.2016.12.2.224.CrossRefPubMedPubMedCentral

68.

Hersh N, Ben Zvi H, Goldstein L, Steiner I, Benninger F. Epilepsy following herpes simplex encephalitis - a case series. Epilepsy Res. 2023;192:107137. https://doi.org/10.1016/j.eplepsyres.2023.107137.CrossRefPubMed

69.

Smith RA, Martland T, Lowry MF. Children with seizures presenting to accident and emergency. J Accid Emerg Med. 1996;13(1):54–8. https://doi.org/10.1136/emj.13.1.54.CrossRefPubMedPubMedCentral

70.

Hampers LC, Spina LA. Evaluation and management of pediatric febrile seizures in the emergency department. Emerg Med Clin North Am. 2011;29(1):83–93. https://doi.org/10.1016/j.emc.2010.08.008.CrossRefPubMed

71.

Armon K, Stephenson T, MacFaul R, Hemingway P, Werneke U, Smith S. An evidence and consensus based guideline for the management of a child after a seizure. Emerg Med J. 2003;20(1):13–20. https://doi.org/10.1136/emj.20.1.13.CrossRefPubMedPubMedCentral

72.

Olson H, Rudloe T, Loddenkemper T, Harper MB, Kimia AA. Should patients with complex febrile seizure be admitted for further management? Am J Emerg Med. 2018;36(8):1386–90. https://doi.org/10.1016/j.ajem.2017.12.059.CrossRefPubMed

73.

Kannikeswaran N, Sivaswamy L, Farooqi A, Sethuraman U. Children with complex febrile seizures: is hospital admission necessary? Clin Pediatr (Phila). 2021;60(8):363–9. https://doi.org/10.1177/00099228211017702.CrossRefPubMed

74.

Capovilla G, Mastrangelo M, Romeo A, Vigevano F. Recommendations for the management of febrile seizures: ad Hoc Task Force of LICE guidelines Commission. Epilepsia. 2009;50(Suppl 1):2–6. https://doi.org/10.1111/j.1528-1167.2008.01963.x.CrossRefPubMed

75.

Guidelines for the management of convulsions with fever. Joint Working Group of the Research Unit of the Royal College of Physicians and the British Paediatric Association. BMJ. 1991;303(6803):634–6. https://doi.org/10.1136/bmj.303.6803.634.CrossRef

76.

Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med. 1976;295(19):1029–33. https://doi.org/10.1056/NEJM197611042951901.CrossRefPubMed

77.

Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures. Pediatrics. 1978;61(5):720–7.CrossRefPubMed

78.

Hamati-Haddad A, Abou-Khalil B. Epilepsy diagnosis and localization in patients with antecedent childhood febrile convulsions. Neurology. 1998;50(4):917–22. https://doi.org/10.1212/wnl.50.4.917.CrossRefPubMed

79.

Berg AT, Shinnar S, Darefsky AS, Holford TR, Shapiro ED, Salomon ME, et al. Predictors of recurrent febrile seizures. A prospective cohort study. Arch Pediatr Adolesc Med. 1997;151(4):371–8. https://doi.org/10.1001/archpedi.1997.02170410045006.CrossRefPubMed

80.

Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med. 1987;316(9):493–8. https://doi.org/10.1056/NEJM198702263160901.CrossRefPubMed

81.

Pavlidou E, Panteliadis C. Prognostic factors for subsequent epilepsy in children with febrile seizures. Epilepsia. 2013;54(12):2101–7. https://doi.org/10.1111/epi.12429.CrossRefPubMed

82.

Canpolat M, Per H, Gumus H, Elmali F, Kumandas S. Investigating the prevalence of febrile convulsion in Kayseri, Turkey: an assessment of the risk factors for recurrence of febrile convulsion and for development of epilepsy. Seizure. 2018;55:36–47. https://doi.org/10.1016/j.seizure.2018.01.007.CrossRefPubMed

83.

Greenwood R, Golding J, Ross E, Verity C. Prenatal and perinatal antecedents of febrile convulsions and afebrile seizures: data from a national cohort study. Paediatr Perinat Epidemiol. 1998;12(Suppl 1):76–95. https://doi.org/10.1046/j.1365-3016.1998.0120s1076.x.CrossRefPubMed

84.

Nelson KB, Ellenberg JH. Prenatal and perinatal antecedents of febrile seizures. Ann Neurol. 1990;27(2):127–31. https://doi.org/10.1002/ana.410270206.CrossRefPubMed

85.

el-Radhi AS, Withana K, Banajeh S. Recurrence rate of febrile convulsion related to the degree of pyrexia during the first attack. Clin Pediatr (Phila). 1986;25(6):311–3. https://doi.org/10.1177/000992288602500606.CrossRefPubMed

86.

Leung AK, Hon KL, Leung TN. Febrile seizures: an overview. Drugs Context. 2018;7:212536. https://doi.org/10.7573/dic.212536.CrossRefPubMedPubMedCentral

87.

Annegers JF, Hauser WA, Elveback LR, Kurland LT. The risk of epilepsy following febrile convulsions. Neurology. 1979;29(3):297–303. https://doi.org/10.1212/wnl.29.3.297.CrossRefPubMed

88.

Verity CM, Ross EM, Golding J. Outcome of childhood status epilepticus and lengthy febrile convulsions: findings of national cohort study. BMJ. 1993;307(6898):225–8. https://doi.org/10.1136/bmj.307.6898.225.CrossRefPubMedPubMedCentral

89.

Loussouarn A, Devlin A, Bast T, Benoist G, Corrard F, Cross H, et al. Consensus statements on the information to deliver after a febrile seizure. Eur J Pediatr. 2021;180(9):2993–9. https://doi.org/10.1007/s00431-021-04067-2.CrossRefPubMed

90.

Uhari M, Rantala H, Vainionpää L, Kurttila R. Effect of acetaminophen and of low intermittent doses of diazepam on prevention of recurrences of febrile seizures. J Pediatr. 1995;126(6):991–5. https://doi.org/10.1016/s0022-3476(95)70231-8.CrossRefPubMed

91.

van Stuijvenberg M, Derksen-Lubsen G, Steyerberg EW, Habbema JD, Moll HA. Randomized, controlled trial of ibuprofen syrup administered during febrile illnesses to prevent febrile seizure recurrences. Pediatrics. 1998;102(5):E51. https://doi.org/10.1542/peds.102.5.e51.CrossRefPubMed

92.

Strengell T, Uhari M, Tarkka R, Uusimaa J, Alen R, Lautala P, et al. Antipyretic agents for preventing recurrences of febrile seizures: randomized controlled trial. Arch Pediatr Adolesc Med. 2009;163(9):799–804. https://doi.org/10.1001/archpediatrics.2009.137.CrossRefPubMed

93.

Hashimoto R, Suto M, Tsuji M, Sasaki H, Takehara K, Ishiguro A, et al. Use of antipyretics for preventing febrile seizure recurrence in children: a systematic review and meta-analysis. Eur J Pediatr. 2021;180(4):987–97. https://doi.org/10.1007/s00431-020-03845-8.CrossRefPubMed

94.

Offringa M, Newton R, Nevitt SJ, Vraka K. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2021;6(6):CD003031. https://doi.org/10.1002/14651858.CD003031.pub4.CrossRefPubMed

95.

Baumann RJ, Duffner PK. Treatment of children with simple febrile seizures: the AAP practice parameter. American Academy of Pediatrics. Pediatr Neurol. 2000;23(1):11–7. https://doi.org/10.1016/s0887-8994(00)00148-x.CrossRefPubMed

96.

Wassner E, Morris B, Fernando L, Rao M, Whitehouse WP. Intranasal midazolam for treating febrile seizures in children. Buccal midazolam for childhood seizures at home preferred to rectal diazepam. BMJ. 2001;322(7278):108.PubMed

97.

Deng L, Danchin M, Lewis G, Cheung A, Campbell AJ, Wadia U, et al. Revaccination outcomes of children with vaccine proximate seizures. Vaccine. 2021;39(11):1565–71. https://doi.org/10.1016/j.vaccine.2021.02.016.CrossRefPubMed

98.

Hu MH, Lin KL, Wu CT, Chen SY, Huang GS. Clinical characteristics and risk factors for seizures Associated with Norovirus Gastroenteritis in Childhood. J Child Neurol. 2017;32(9):810–4. https://doi.org/10.1177/0883073817707302.CrossRefPubMed

99.

Hirtz DG, Nelson KB, Ellenberg JH. Seizures following childhood immunizations. J Pediatr. 1983;102(1):14–8. https://doi.org/10.1016/s0022-3476(83)80278-9.CrossRefPubMed

100.

Brown NJ, Berkovic SF, Scheffer IE. Vaccination, seizures and vaccine damage. Curr Opin Neurol. 2007;20(2):181–7. https://doi.org/10.1097/WCO.0b013e3280555160.CrossRefPubMed

101.

Bakken IJ, Aaberg KM, Ghaderi S, Gunnes N, Trogstad L, Magnus P, et al. Febrile seizures after 2009 influenza A (H1N1) vaccination and infection: a nationwide registry-based study. BMC Infect Dis. 2015;15:506. https://doi.org/10.1186/s12879-015-1263-7.CrossRefPubMedPubMedCentral

102.

Prymula R, Siegrist CA, Chlibek R, Zemlickova H, Vackova M, Smetana J, et al. Effect of prophylactic Paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet. 2009;374(9698):1339–50. https://doi.org/10.1016/S0140-6736(09)61208-3.CrossRefPubMed

103.

Ellenberg JH, Nelson KB. Febrile seizures and later intellectual performance. Arch Neurol. 1978;35(1):17–21. https://doi.org/10.1001/archneur.1978.00500250021004.CrossRefPubMed

104.

Verity CM, Greenwood R, Golding J. Long-term intellectual and behavioral outcomes of children with febrile convulsions. N Engl J Med. 1998;338(24):1723–8. https://doi.org/10.1056/NEJM199806113382403.CrossRefPubMed

105.

Sillanpää M, Suominen S, Rautava P, Aromaa M. Academic and social success in adolescents with previous febrile seizures. Seizure. 2011;20(4):326–30. https://doi.org/10.1016/j.seizure.2010.12.019.CrossRefPubMed

106.

Nørgaard M, Ehrenstein V, Mahon BE, Nielsen GL, Rothman KJ, Sørensen HT. Febrile seizures and cognitive function in young adult life: a prevalence study in Danish conscripts. J Pediatr. 2009;155(3):404–9. https://doi.org/10.1016/j.jpeds.2009.04.003.CrossRefPubMed

107.

Martinos MM, Yoong M, Patil S, Chong WK, Mardari R, Chin RF, et al. Early developmental outcomes in children following convulsive status epilepticus: a longitudinal study. Epilepsia. 2013;54(6):1012–9. https://doi.org/10.1111/epi.12136.CrossRefPubMed

108.

Shinnar RC, Shinnar S, Hesdorffer DC, O’Hara K, Conklin T, Cornett KM, et al. Parental stress, pediatric quality of life, and behavior at baseline and one-year follow-up: results from the FEBSTAT study. Epilepsy Behav. 2017;69:95–9.CrossRefPubMedPubMedCentral

109.

Martinos MM, Yoong M, Patil S, Chin RF, Neville BG, Scott RC, et al. Recognition memory is impaired in children after prolonged febrile seizures. Brain. 2012;135(Pt 10):3153–64. https://doi.org/10.1093/brain/aws213.CrossRefPubMedPubMedCentral

110.

Martinos MM, Pujar S, O’Reilly H, de Haan M, Neville BGR, Scott RC, et al. Intelligence and memory outcomes within 10 years of childhood convulsive status epilepticus. Epilepsy Behav. 2019;95:18–25. https://doi.org/10.1016/j.yebeh.2019.03.039.CrossRefPubMedPubMedCentral

111.

Scott RC, Gadian DG, King MD, Chong WK, Cox TC, Neville BG, et al. Magnetic resonance imaging findings within 5 days of status epilepticus in childhood. Brain. 2002;125(Pt 9):1951–9. https://doi.org/10.1093/brain/awf202.CrossRefPubMed

112.

Lewis DV, Shinnar S, Hesdorffer DC, Bagiella E, Bello JA, Chan S, et al. Hippocampal sclerosis after febrile status epilepticus: the FEBSTAT study. Ann Neurol. 2014;75(2):178–85. https://doi.org/10.1002/ana.24081.CrossRefPubMedPubMedCentral

113.

Kasperaviciute D, Catarino CB, Matarin M, Leu C, Novy J, Tostevin A, et al. Epilepsy, hippocampal sclerosis and febrile seizures linked by common genetic variation around SCN1A. Brain. 2013;136(Pt 10):3140–50. https://doi.org/10.1093/brain/awt233.CrossRefPubMedPubMedCentral

114.

Specchio N, Pietrafusa N, Bellusci M, Trivisano M, Benvenga A, de Palma L, et al. Pediatric status epilepticus: identification of prognostic factors using the new ILAE classification after 5 years of follow-up. Epilepsia. 2019;60(12):2486–98. https://doi.org/10.1111/epi.16385.CrossRefPubMed

115.

Vestergaard M, Pedersen MG, Ostergaard JR, Pedersen CB, Olsen J, Christensen J. Death in children with febrile seizures: a population-based cohort study. Lancet. 2008;372(9637):457–63. https://doi.org/10.1016/S0140-6736(08)61198-8.CrossRefPubMed

116.

Vestergaard M, Basso O, Henriksen TB, Østergaard J, Olsen J. Febrile convulsions and sudden infant death syndrome. Arch Dis Child. 2002;86(2):125–6. https://doi.org/10.1136/adc.86.2.125.CrossRefPubMedPubMedCentral

117.

Baumer JH, David TJ, Valentine SJ, Roberts JE, Hughes BR. Many parents think their child is dying when having a first febrile convulsion. Dev Med Child Neurol. 1981;23(4):462–4. https://doi.org/10.1111/j.1469-8749.1981.tb02019.x.CrossRefPubMed

118.

Crandall LG, Lee JH, Stainman R, Friedman D, Devinsky O. Potential role of febrile seizures and other risk factors Associated with Sudden deaths in children. JAMA Netw Open. 2019;2(4):e192739. https://doi.org/10.1001/jamanetworkopen.2019.2739.CrossRefPubMedPubMedCentral

119.

Trivisano M, Muccioli L, Ferretti A, Lee HF, Chi CS, Bisulli F. Risk of SUDEP during infancy. Epilepsy Behav. 2022;131(Pt B):107896. https://doi.org/10.1016/j.yebeh.2021.107896.CrossRefPubMed

120.

Pujar SS, Neville BG, Scott RC, Chin RF, North London Epilepsy Research Network. Death within 8 years after childhood convulsive status epilepticus: a population-based study. Brain. 2011;134(Pt 10):2819–27. https://doi.org/10.1093/brain/awr239.CrossRefPubMedPubMedCentral

121.

van Stuijvenberg M, de Vos S, Tjiang GC, Steyerberg EW, Derksen-Lubsen G, Moll HA. Parents’ fear regarding fever and febrile seizures. Acta Paediatr. 1999;88(6):618–22. https://doi.org/10.1080/08035259950169260.CrossRefPubMed

122.

Huang MC, Liu CC, Huang CC. Effects of an educational program on parents with febrile convulsive children. Pediatr Neurol. 1998;18(2):150–5. https://doi.org/10.1016/s0887-8994(97)00171-9.CrossRefPubMed

123.

Rugg-Gunn FJ, Harrison NA, Duncan JS. Evaluation of the accuracy of seizure descriptions by the relatives of patients with epilepsy. Epilepsy Res. 2001;43(3):193–9. https://doi.org/10.1016/s0920-1211(00)00209-6.CrossRefPubMed

124.

Falsaperla R, Marino S, Vitaliti G, Bonadies A, Marino SD, Pavone P, et al. Simple febrile seizures: new cut off for the duration of the crises. Acta Neurol Belg. 2023;123(4):1339–44. https://doi.org/10.1007/s13760-023-02211-3.CrossRefPubMed

125.

Abou-Khalil B, Krei L, Lazenby B, Harris PA, Haines JL, Hedera P. Familial genetic predisposition, epilepsy localization and antecedent febrile seizures. Epilepsy Res. 2007;73(1):104–10. https://doi.org/10.1016/j.eplepsyres.2006.08.005.CrossRefPubMed

Title: Best practices for the management of febrile seizures in children
Authors: Alessandro Ferretti
Antonella Riva
Alice Fabrizio
Oliviero Bruni
Giuseppe Capovilla
Thomas Foiadelli
Alessandro Orsini
Umberto Raucci
Antonino Romeo
Pasquale Striano
Pasquale Parisi
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Febrile Seizure
Epilepsy
Published in: Italian Journal of Pediatrics / Issue 1/2024
Electronic ISSN: 1824-7288
DOI: https://doi.org/10.1186/s13052-024-01666-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Best practices for the management of febrile seizures in children

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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