Febrile seizures in the emergency department

Febrile seizures (FS) are the most common neurological disorder in children aged 6months to 5 years. These seizures are typically benign and occur during a febrile event(at least 38°C), without the presence of central nervous system infections, metabolicdisorders, or a history of epilepsy.The cause of FS seems to be multifactorial. Genetic predisposition has beenrecognized, although the mode of inheritance is not well known. Fever as a triggerof FS is requisite and up to 82 % of FS occur during viral infections, while bacterialinfections are less often as a trigger. Febrile seizures are categorized as: simple orcomplex. Division is based on the presence of focal signs, duration and recurrencewithin a single infectious episode.Prehospital and emergency management should address primarily on stabilizing thechild ABC’s (airway, breathing and circulation). Most febrile seizures will resolvebefore children arrive at the Emergency Department. For those that have not resolvedand are lasting more than five minutes, benzodiazepine is recommended to terminatethe seizure. Rectal diazepam and buccal midazolam are the first choice as rescuetherapy, especially if IV access is not available. Prognosis is favorable and there is alow risk of developing epilepsy.