Pediatric Febrile Seizures Clinical Presentation

Updated: Nov 17, 2016
  • Author: Robert J Baumann, MD; Chief Editor: Amy Kao, MD  more...
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Presentation

History

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  • Children with simple febrile seizures are neurologically and developmentally healthy before and after the seizure.
  • They do not experience a seizure in the absence of fever.
  • The seizure is described as either a generalized clonic or a generalized tonic-clonic seizure.
    • Signs of a focal seizure during the onset or in the postictal period (eg, initial clonic movements of 1 limb or of the limbs on 1 side, a weak limb postictally) would rule out a simple febrile seizure.
    • Similarly, simple febrile seizure activity does not continue for more than 15 minutes, although a postictal period of sleepiness or confusion can extend beyond the 15-minute maximum.
  • Simple febrile seizures often occur with the initial temperature elevation at the onset of illness. The seizure may be the first indication that the child is ill. While no clear cutoff is known, a rectal temperature under 38°C should raise concern that the event was not a simple febrile seizure.
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Physical

Physical examination findings reveal a neurologically and developmentally healthy child. It is especially important that the child have no signs of meningitis or encephalitis (eg, stiff neck or persistent mental status changes).

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Causes

Simple febrile seizures are considered a genetic disorder, but neither a specific locus nor a specific pattern of inheritance has been described. The mode of inheritance is likely to vary between families and may be multifactorial.

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