Febrile Seizure

Initial evaluation and acute management

• 1. History
• 2. Exam
• 3. Manage acute febrile seizure and acute illness (first aid, midazolam, diazepam, diagnostic tests) as needed
• 4. Determine risk factors for recurrence and estimate risk of recurrence of the febrile seizures

Counseling

• Counsel parents about risk of recurrence and how to provide first aid and manage fever

Risk stratification

• Determine risk factors for later epilepsy

Low risk (vast majority of cases)

• No therapy or investigations are necessary

High risk (minority of cases)

• 1. Consider EEG and imaging
• 2. Consider intermittent oral diazepam or, in exceptional cases that recur, continuous therapy