Febrile seizures: recent developments and unanswered questions

BACKGROUND: Febrile seizures (FS) are typically observed in infants and children affecting 2-5 % of the pediatric population and are the commonest seizures in childhood.

OBJECTIVES: The present review summarizes epidemiology, etiology, clinical picture, and diagnostic procedures as well as the therapeutic options and the different courses this disorder may take.

METHOD: An extensive review of literature is performed, while views and aspects towards the pathogenesis of FS are stated. Risk factors for multiple recurrences of FS and for subsequent epilepsy are analyzed. Questions regarding the treatment and follow-up of children with FS are answered.

RESULTS: Whereas the frequency of epilepsy following simple FS is estimated to be 1.0-2.2 % of patients, and thus does not differ from the risk of normal population, complicated FS are associated with an increased risk of subsequent epilepsy in 4.1-6.0 %. Febrile status epilepticus with focal symptoms may result in approximately 5 % of cases in complex partial epilepsy. Furthermore, multiple recurrences increase the risk for generalized epilepsy (>4 %). The immediate management of FS, intermittent prophylaxis, and the effectiveness of the treatment in combination with antipyretics are presented in detail.

CONCLUSION: FS can cause a great anxiety and even panic to parents and to the whole family. Parents should be educated about the benign condition and the good prognosis. Although much information has been gained, much remains to be learned.