Clinical Practice Guideline On First Simple Febrile Seizure

Simple Febrile Seizure

Seizure occurring in healthy children ages 3 months to 6 years, with axillary temperature of 37.8 Celcius or greater, characterized as generalized tonic-clonic seizures, lasting for less than 15 minutes and which does not recur within the same febrile illness. The neurologic examination is normal and there is no underlying CNS infection or abnormality.

A. Neurodiagnostic Procedures I. Lumbar Puncture (LP)

Lumbar puncture should be performed in all children below 18 months for a first simple febrile seizure. For those children 18 monthe of age, lumbar puncture should be performed in the presence of clinical signs of meningitis (e.g. presence of meningeal signs, sensorial changes).

II.

Neuroimaging ( Cranial Ultrasound, CT Scan, MRI )

Neuroimaging studies should not be routinely performed in children for a first simple febrile seizure.

B. Therapeutic Intervention I. Antipyretic Use

Antipyretic drugs are used to lower fever and should not be relied upon to prevent the recurrence of febrile seizures.

II.

Antiepileptic Drug Use continuous anticonvulsant (Phenobarbital or valproic acid)

The use of continuous anticonvulsant is not recommended in children after a first simple febrile seizure. Although anticonvulsants can reduce the recurrence of febrile seizures, the adverse effects of these do not warrant their use in thus benign disorder.

III.

Antiepileptic Drug Use intermittent anticonvulsant (Phenobarbital or Diazepam)

The use of intermittent anticonvulsant (whether Phenobarbital or Diazepam) is not recommended for the prevention of recurrent febrile seizures.

C. Prognostic Evaluation I. Electroencephalogram (EEG)

Electroencephalogram should not be routinely requested in children with a first simple febrile seizure.

Reference: Philippine Pediatric Society

Western Visayas Medical Center Department of Pediatrics

Clinical Practice Guideline

On First Simple Febrile Seizure