Febrile Seizures: Four Steps Algorithmic Clinical Approach

Febrile seizures (FS) are the most common form of convulsive phenomena in human being and affect 2% to 14% of children. It is the most common type of seizures that every pediatrician is dealing with. It is the most benign type of all seizures occurring in childhood. There are many debates on how to approach to febrile seizures in pediatric neurology and there are many possible malpractices in this field. Some of the most common frequent queries are: How could we differentiate FS from seizures and fever associated with serious infections involving the central nervous system? When should we refer the affected child for further investigations such as lumbar puncture, EEG, neuroimaging, and routine biochemical studies? How should we treat FS in its acute phase? How could we assess the risk for further recurrences as well as other risks threatening the child's health in future? How could we select the patients for treatment or prophylaxis? Which medication(s) should be selected for treatment or prophylaxis? Trying to answer the above-mentioned questions, this review article will present a four steps algorithmic clinical approach model to a child with febrile seizures based on the current medical literature.