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You are seeing an 18-month-old brought in by ambulance for simple febrile seizure that lasted 2 minutes. You have determined the source of his fever to be viral URI with acute otitis media. He has fully recovered, his temperature has normalized (from 40C) with antipyretic, and he is interactive and playful now. His neurologic exam is normal, and he has no significant past medical history. His parents are asking about whether this will happen again, whether he is at higher risk of epilepsy, and whether he will have any negative neurologic outcome.
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July 23, 2023 at 9:43 pm
C) Overall, about 1/3 of children with febrile seizures will have another
Risk of recurrence is higher in those who: have a younger age at onset of febrile seizure, have a positive family history in a first-degree relative of febrile seizures, had a lower degree of fever at the time of the febrile seizure, and have a briefer duration of time between onset of fever and seizure. Giving antipyretics has not been shown to affect recurrence with subsequent febrile illnesses; caretakers should not be made to feel responsible for preventing subsequent seizures. Neurologic sequelae are vanishingly rare after simple febrile seizure in a developmentally normal child, and there is no evidence for differences in academic performance. Children who have had a febrile seizure do have a very slightly higher risk of epilepsy than the general population (1-2%), while those who have had a complex febrile seizure, abnormal development, or family history of epilepsy have a much higher risk (5-10%).