Evaluation and management of febrile seizures in the out-of-hospital and emergency department settings

Warden, Craig R.; Zibulewsky, Joseph; Mace, Sharon; Gold, Claudia; Gausche-Hill, Marianne

doi:10.1067/mem.2003.48

« Previous Next »Annals of Emergency Medicine
Volume 41, Issue 2 , Pages 215-222, February 2003

Evaluation and management of febrile seizures in the out-of-hospital and emergency department settings☆

Department of Emergency Medicine, Oregon Health & Science University/Doernbecher Children's Hospital, Portland, OR (Warden); the Department of Emergency Medicine, Baylor University Medical Center, Dallas, TX (Zibulewsky); the Department of Emergency Medicine, Cleveland Clinic Foundation, and Ohio State University School of Medicine, Cleveland, OH (Mace); Children's Hospital of Orange County, Orange, CA (Gold); and the Department of Emergency Medicine, Little Company of Mary Hospital, and UCLA School of Medicine, Harbor–UCLA Medical Center, Torrance, CA (Gausche-Hill)

Received 10 May 2002; received in revised form 18 September 2002 and 2 October 2002; accepted 7 October 2002.

Address for correspondence: Craig R. Warden, MD, MPH, Department of Emergency Medicine, Oregon Health & Science University, Mailstop CDW-EM, 3181 SW Sam Jackson Park Road, Portland, OR 97201; 503-494-4399; E-mail wardenc@ohsu.edu.

Abstract

Febrile seizures are the most common seizures seen in children younger than 5 years old. Out-of-hospital and emergency department providers need to be familiar with the principles of the evaluation and management of this common disorder. Most febrile seizures are brief, do not require any specific treatment or extensive workup, and have a benign prognosis. Recognizing the pattern of a simple febrile seizure in young children is important to limit interventions and to reassure parents. Patients with febrile seizures are not at higher risk for serious bacterial illnesses than similarly aged febrile patients. Excluding meningitis and encephalitis are the primary clinical interventions through a thorough history and physical examination and, occasionally, a lumbar puncture. Reassuring parents of patients with febrile seizures and arranging primary care follow-up are important roles for the emergency physician. [Ann Emerg Med. 2003;41:215–222.]