Brief (<15 min), generalized, tonic-clonic seizure associated with a febrile illness, but without any CNS infection, severe metabolic disturbance, or other known neurological cause

The most common seizure disorder during childhood

Age: 6 m/o ~ 5 y/o Incidence: 2% ~ 4% in children

<5 y/o Peak age of onset: 18 ~ 22 m/o Sex: male = female Strong family history in siblings and pa

rents: increase risk 2~3 times

Viral URI Reseola Acute otitis media

80~90% of cases Occur early when core

temperature reaches 39 C or greater

Generalized, tonic-clonic for seconds to 15-min, followed by a postictal period of drowsiness

Age < 6 m/o or > 5 y/o Onset >24 hr after fever onset Duration >15 min Occur more than once in 24 hr Focal motor manifestations Abnormal neurological

examination

Typical: not required Atypical: required

• EEG• Toxicology screening• Assessment of electrolytes• CT or MRI

Routine treatment:• Search for the cause of fever• Control fever (avoid excessive clothing, encourage fluids, tepid sponge bath, and antipyretics)

Prophylactic anticonvulsants are not indicated for typical febrile convulsion

Excellent prognosis in most children

Risk of recurrence:• Onset < 1 y/o or with family history: 50%

• Onset > 1 y/o: 30 % up to the age of 5 yr

• After second episode: 50 %• Age > 5 y/o: near zero

Risk of epilepsy development:• 1~2% in the general population

• increase up to 9% when two or more risk factors are present

Risk factors for epilepsy development:• Positive family history of epilepsy• Atypical febrile convulsion• Previous abnormal development or neurological disorder

Antipyretic agents: ineffective Diazepam: effective and safe

• Oral or rectal form• For patients with frequent febrile convulsion or significant parental anxiety

• Dose: 0.3 mg/kg q8h PO (1 mg/kg/d) for the duration of the illness (2~3 days)

• Side effects: lethargy, irritable, ataxia

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