Prevalence
~3% of children.

Incidence
460/100,000 in the age group 0 to 4 years.

Age at onset
6 months to 5 years; peak at 18 to 22 months.

Sex
Males (60%) slightly predominate.

Neurological and mental state
Normal.

Etiology
Often familial.

Clinical manifestations
Main types of seizures: generalized tonic-clonic seizures (GTCS; 80%), tonic (13%), atonic (3%), unilateral, or with focal onset tonic-clonic convulsions (4%).

Simple febrile seizures (70%) are GTCS lasting <15 min and without recurrence within the next 24 hours (or within the same febrile illness).

Complex febrile seizures (30%) may last >15 min (8%), have 2 or more recurrences within 24 hours (16%), or show focal or unilateral features (6%).

Seizure-precipitating factors
Fever at least 38ºC.

EEG
Not needed.

Prognosis
6-fold excess (3%) of subsequent epilepsy compared with controls; 2% after simple and 5% to 10% after complex febrile seizures.

Differential diagnosis
Other epilepsies, symptomatic seizures of febrile illnesses.

Management options
Acute management involves control of the seizure and treatment of the fever and of the underlying illness. Termination of long-lasting convulsions is the same as for status epilepticus. Antipyretic treatment during febrile illnesses does not reduce the recurrence rate.

Prophylactic management is usually not needed for simple febrile seizures.

Parental education is mandatory.

This section was adapted from:

The educational kit on epilepsies: The epileptic syndromes By C. P. Panayiotopoulos Originally published by MEDICINAE, 21 Cave Street, Oxford OX4 1BA
First published 2006 and reprinted in 2007. The Educational Kit on Epilepsies was produced through an unrestricted educational grant from UCB Pharma SA.
UCB Pharma SA assumes no responsibility of the views expressed and recommended treatments in these volumes.

Authored by: C. P. Panayiotopoulos MD PhD FRCP on 1/2005
Reviewed by: Steven C. Schachter MD on 6/2008
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