Febrile Seizures in Pediatrics: A Systematic Review of Current Evidence

iBackground: /iFebrile seizures are the most common seizure disorder in childhood, affecting approximately “2–5% of children worldwide”. Although typically benign, they are a frequent cause of emergency department visits and are associated with significant parental anxiety and healthcare utilization. iObjective: /iTo systematically synthesize current evidence on the epidemiology, pathophysiology, diagnostic evaluation, management, and prognosis of febrile seizures in pediatric populations. iMethods: /iA systematic review was conducted in accordance with “PRISMA 2020 guidelines”. Electronic databases, including PubMed, Scopus, and the Cochrane Library, were searched for studies published “up to March 2026”. Eligible studies included clinical practice guidelines, systematic reviews, and observational studies involving children aged 0–18 years. Study selection and eligibility assessment were performed using predefined inclusion and exclusion criteria. Data were extracted on study characteristics, clinical findings, and management strategies. Due to heterogeneity in study designs and outcomes, a qualitative synthesis was performed. The quality of evidence was assessed using a “modified GRADE approach”. iResults: /iA total of “20 studies” met the inclusion criteria and were included in the qualitative synthesis. The evidence consistently indicates that febrile seizures are generally benign and self-limited events. Routine neurodiagnostic testing, including electroencephalography and neuroimaging, is not indicated in simple febrile seizures. Benzodiazepines remain the first-line treatment for prolonged seizures. Prophylactic antiepileptic therapy is not recommended due to an unfavorable risk–benefit profile. Emerging evidence highlights the role of neuroinflammatory pathways and genetic susceptibility in seizure pathophysiology. Recurrence occurs in approximately “30–40% of cases”, while the overall risk of subsequent epilepsy remains low. iConclusion: /iFebrile seizures have a favorable prognosis and should be managed using a conservative, evidence-based approach centered on clinical evaluation, risk stratification, and parental education. Current evidence supports minimizing unnecessary diagnostic and therapeutic interventions. Future research should focus on improving risk stratification and integrating emerging biological insights into clinical practice.