What are the emergent treatment options for pediatric patients with a simple febrile seizure?

Updated: Jul 23, 2019
  • Author: Hina Z Ghory, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Answer

The evaluation of patients presenting with a simple febrile seizure focuses on determining the cause of the fever. In children aged 2-24 months with simple febrile seizures, the risk for occult bacteremia is about the same as that of patients with fever alone.

In children who remain ill appearing and/or who have signs of toxicity, the possibility of meningitis might be considered. [41] Young children with febrile seizures, especially those younger than 12 months may not always reliably demonstrate physical signs of meningitis.

The child with a febrile seizure should be monitored for some time in the ED, and findings on serial examinations should be documented to differentiate children who are ill with occult disease from children who may be safely discharged home. [42]

Lumbar puncture (LP) may be difficult to justify in the child who, after appropriate use of an antipyretic, exhibits normal activity. LP is reserved for the younger patient, the patient already receiving antibiotics, or the patient whose physical findings cause concern.


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