Technical Report Summary: The Neurodiagnostic Evaluation of the Child With a First Simple Febrile Seizure

Abstract

Febrile seizures are a common problem in clinical practice, occurring in 2.7% of children in the British Birth Cohort Study.1 The subcommittee's efforts were focused on the large subgroup of children (88%)1 who have simple febrile seizures, because in the view of most clinicians and on the basis of the epidemiologic evidence, this is a relatively homogeneous clinical grouping2 in terms of age, clinical presentation, course, and outcome.1-3 DEFINITION OF THE PROBLEM Children younger than 5 years who have their first seizure in association with a fever are commonly divided into three groups. Children with simple febrile seizures make up the largest group. The second group includes children whose seizures are secondary to central nervous system (CNS) infection (symptomatic febrile seizures). In the third group, children whose seizures are neither simple nor secondary to CNS infection are classified as having complex febrile seizures. The definition of a simple febrile seizure in this practice parameter corresponds to that in usual clinical practice and is also supported by the analysis of data from the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke.4 In that project, Nelson and Ellenberg4 analyzed the data of 1706 children 7 years of age who had had one or more febrile seizures. The risk of epilepsy (afebrile seizures) was significantly higher for children whose neurological development was not normal before the seizures, whose seizures occurred before 6 months of age, whose seizure lasted longer than 15 minutes, or who had more than one febrile seizure per day.