Complex Febrile Seizures

Abstract

Febrile seizures are the most common type of childhood seizures, affecting 2% to 5% of children. A complex febrile seizure is one with focal onset, one that occurs more than once during a febrile illness, or one that lasts more than 10 to 15 minutes. Confusion still exists on the proper evaluation of a child presenting with a complex febrile seizure. There are ongoing research attempts to determine the link between complex febrile seizures and epilepsy. Further clarification and understanding of this disorder would be of great benefit to primary care providers and child neurologists.

Febrile seizures

“…Performing EEG within 24 hours of presentation can show generalized background slowing, which could make identifying possible epileptiform abnormalities difficult. Generalized slowing on EEG can be present up to 7 days after a child presents with febrile status epilepticus 24 , 55) . The reported incidence of EEG abnormalities in children with FS varies from 2% to 86% 52 , 53 , 54) .…”

“…A pre-existing lesion can increase the propensity for further focally prolonged seizures and thus cause further hippocampal damage 24) . A recent study found MRI abnormalities in 14.8% of children with complex FS, while only 11.4% of 159 children with simple FS had imaging abnormalities; however, this was not statistically significant 58) .…”

“…These children are reported to have a variety of mutations in the α-subunit of the sodium channel (SCN1A and B) 22 , 23) , and in the γ 2 -subunit of the γ-aminobutyric acid type A (GABAA) receptor (GABRG2) 22 , 24) .…”

“…It is important that physicians play a vital role in reassuring families about the prognosis, including risks of seizure recurrence, neurologic morbidity, and mortality after FS, alleviate their anxiety, and let them return to normal life 15) . Approaches to the treatment of FS are based on (1) the immediate treatment of prolonged or cluster seizures, (2) intermittent treatment at the time of illness, and (3) continuous anticonvulsant therapy for prophylaxis of FS 12 , 24) .…”

Abordaje de las convulsiones febriles en la infancia.

“…El electroencefalograma se recomienda únicamente en pacientes con una convulsión febril compleja o estatus epiléptico febril y en pacientes con convulsiones febriles recurrentes. También se recomienda realizarlo en niños que tengan algún retraso en su neurodesarrollo (11). En los casos de convulsiones simples, este estudio no tiene ninguna utilidad (4).…”