Febrile seizures: the current situation

Febrile seizures are the most frequent neurologic disorders during childhoo d. The pathogenesis is not clear even today. Viral infections of the upper airways, exanthema subitum, acute otitis media, infection of the urinary tr act and febrile reactions after vaccination are the most frequent precipita ting factors. Predictors in identifying children with very high risk of rec urrence are young age at onset, family history of febrile seizures in a fir st-degree relative, a history of recurrent febrile seizures and a lower deg ree of fever at the onset of febrile seizures. A family history of epilepsy neurodevelopmental abnormalities and a lower degree of fever at the onset of febrile convulsion are predictors of later epilepsy in children who have febrile seizures. The prognosis of febrile seizures is very good. In the a cute situation, rectal diazepam should be given in the event of prolonged f ebrile seizures (>3 minutes) only. Intermittent diazepam therapy and long-t erm antiepileptics are not recommended. The best prophylactic treatment is education and reassurance for parents and children.