Febrile seizures.

BACKGROUND Febrile convulsions, or febrile seizures, are frequently encountered in paediatrics, and despite often being self limiting, these seizures strike fear in the hearts of patients' carers. OBJECTIVE This article reviews the assessment and management of febrile seizures in children. DISCUSSION The initial assessment of a child who convulses with fever should be directed at finding a cause for the fever, rather than the seizure itself, once the seizure has abated. A lumbar puncture should be performed if there is clinical suspicion of meningitis. Electroencephalograms and neuroimaging studies are not routinely indicated. Overall, febrile seizures carry a good prognosis, although one-third of children have recurrent attacks. Febrile seizures are genetic in origin. The risk of later epilepsy is small but increased if the child has a complex febrile seizure, neurological deficit, or a family history of epilepsy. Carers should be counselled in the management of seizures. The effectiveness of prophylactic treatment with medication remains controversial.