Febrile seizure

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Febrile seizures are common between 6 months and 5 years, do not cause brain damage, and only slightly raise the chance of later epilepsy. About one in three children will have another febrile seizure with a future fever. Recommended supportive care with tylenol or motrin as needed for comfort, with an emphasis on hydration; fever medicine helps comfort but does not prevent febrile seizures. If another seizure happens, lay the child on their side in a safe place, put nothing in the mouth, and time it. Call 911 for a seizure lasting more than 5 minutes, trouble breathing, or blue color. Return precautions given including a stiff neck, unusual sleepiness, repeated vomiting, another seizure, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Febrile seizure
• Simple febrile seizure: generalized, less than 15 minutes, without recurrence within 24 hours
• Back to baseline with a nonfocal neurologic exam and no meningeal signs
• Immunizations up to date and no recent antibiotics
• Fever likely from a viral illness
• No EEG, blood tests, or neuroimaging indicated
• Home after shared decision making; emergency department evaluation not needed
• Follow up as needed

Febrile seizures are common between 6 months and 5 years, do not cause brain damage, and only slightly raise the chance of later epilepsy. About one in three children will have another febrile seizure with a future fever. Recommended supportive care with tylenol or motrin as needed for comfort, with an emphasis on hydration; fever medicine helps comfort but does not prevent febrile seizures. If another seizure happens, lay the child on their side in a safe place, put nothing in the mouth, and time it. Call 911 for a seizure lasting more than 5 minutes, trouble breathing, or blue color. Return precautions given including a stiff neck, unusual sleepiness, repeated vomiting, another seizure, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Simple vs complex definition
Back to baseline, nonfocal, no meningeal signs
Identify the source of fever
LP for meningeal signs
LP option at 6-12 months if Hib/pneumococcal deficient
LP option if pretreated with antibiotics
No EEG, labs, neuroimaging
Recurrence about one-third; benign prognosis
Antipyretics don't prevent febrile seizures
Roseola causes 20-30% of first febrile seizures

Febrile seizure

Febrile seizure

What the sources cover

Used to decide, kept out of the note

Return precautions in the template

Sources