Evidence base: Febrile seizures

A summary of the clinical trials, guidelines, key texts and online resources to help in the management of febrile seizures

Advise parents to place the child in the recovery position and clear the  area around them (Photograph: Science Photo Library)
Advise parents to place the child in the recovery position and clear the area around them (Photograph: Science Photo Library)

Clinical trials
Although many studies have been published looking into all aspects of febrile seizures, there are still many unanswered questions surrounding their pathogenesis and inheritance.

  • Strengell T, Uhari M, Tarkka R, et al. Antipyretic agents for preventing recurrences of febrile seizures. Arch Pediatr Adolesc Med 2009; 163(9): 799-804.

This study observed 231 children for two years and found that antipyretics are ineffective in preventing febrile seizures.

  • Rosman NP, Colton T, Labazzo J, et al. A controlled trial of diazepam administered during febrile illness to prevent recurrence of febrile seizures. N Engl J Med 1993; 329: 79-84.

This study followed 406 children for 1.9 years. It found that treatment with diazepam led to a reduction of 44 per cent in the risk of febrile seizures per child per year.

Guidelines

  • Waruiru C and Appleton R. Febrile seizures: an update. Arch Dis Child 2004; 89(8):751-6.

Hospitals have used this review to produce local guidelines for the management of patients with febrile seizures.

  • NICE. Feverish illness in children: Assessment and initial management in children younger than five years. CG47, London, NICE, 2007.

Although there is no specific NICE guideline for febrile seizures, the fever guideline specifically looks at the indications for further investigation of fever and indications for admission to hospital.

Key text
Panayiotopoulos CP. A Clinical Guide to Epileptic Syndromes and their Treatment. (Second Edition). London, Springer-Verlag, 2007.

This is a good textbook for information regarding any kind of childhood seizure.

Curriculum
This topic is covered in the GP curriculum in statement 15.7 Neurological Problems

Online

This NHS website has information for parents and caregivers of children with febrile seizures.

Contributed by Dr Kathryn Deakin, consultant paediatrician, Pinderfields General Hospital, Wakefield, West Yorkshire


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