Febrile convulsions are seizures that occur between 6-60 months of age associated with a fever but are not caused by infection or metabolic imbalance. They are classified as simple if they last less than 15 minutes and do not recur within 24 hours, or complex if they are longer, focal, or recurrent. Risk factors for recurrence include age under 1 year at first seizure and family history. Risk factors for developing epilepsy include early onset and presence of genetic epilepsy syndromes like GEFS+ or Dravet syndrome. Evaluation involves history, exam to rule out infection, and bloodwork. Treatment is typically not needed beyond fever control and education.

1. Febrile Convulsion

2. Objectives
1. Define febrile convulsion and its criteria.
2. Risk factors for recurrence
3. Risk factors for epilepsy in a child with febrile convulsion
4. How to manage febrile convulsion

3. Definition
Febrile seizures are seizures that occur between the age of 6 and 60 mo with a
temperature of 38°C (100.4°F) or higher, that are not the result of central nervous
system infection or any metabolic imbalance, and that occur in the absence of a history
of prior afebrile seizures

4. criteria
● Simple febrile seizure is a primary generalized, usually tonic–clonic, attack
associated with fever, lasting for a maximum of 15 min, and not recurrent within a
24-hr period.
Most patients with simple febrile seizures have a very short postictal state and
usually return to their baseline normal behavior and consciousness within
minutes of the seizure.
● A complex febrile seizure is more prolonged (>15 min), is focal, and/or reoccurs
within 24 hr.
● Febrile status epilepticus is a febrile seizure lasting longer than 30 min.
● Some use the term simple febrile seizure plus for those with recurrent febrile
seizures within 24 hr.

5. Risk factors for recurrence what the risk for devolping
epilepsy ?
● Febrile seizures recur in approximately 30% of those experiencing a first episode,
in 50% after 2 or more episodes, and in 50% of infants younger than 1 yr old at
febrile seizure onset.

6. ● positive family history for febrile seizures in many patients.
●Almost any type of epilepsy can be preceded by febrile seizures, and a few epilepsy syndromes typically
start with febrile seizures. These are generalized epilepsy with febrile seizures plus (GEFS+), severe
myoclonic epilepsy of infancy (also called Dravet syndrome
●GEFS+ is an autosomal dominant syndrome with a highly variable phenotype. Onset is usually in early
childhood and remission is usually in mid-childhood. It is characterized by multiple febrile seizures and
by several subsequent types of afebrile generalized seizures, including generalized tonic–clonic, absence,
myoclonic, atonic, or myoclonic astatic seizures with variable degrees of severity. A focal febrile seizures
plus epilepsy variant, in which the seizures are focal rather than generalized, has also been described.
●Dravet syndrome is the most severe of the phenotypic spectrum of febrile seizure-associated epilepsies.
It distincted entity in the onset in infancy. Its onset is characterized by febrile and afebrile unilateral
clonic seizures recurring every 1 or 2 mo. These early seizures are typically induced by fever, but they
differ from the usual febrile convulsions in that they are more prolonged, are more frequent, are focal
and come in clusters. Seizures subsequently start to occur with lower fevers and then without fever.
During the 2nd yr of life, myoclonus, atypical absences, and partial seizures occur frequently and
developmental delay usually follows.
Genetic factors

7. Evaluation
● history and a thorough general and neurologic examination, consider infection
● Lumbar Puncture Meningitis should be considered in the differential diagnosis,
and lumbar puncture should be performed for all infants younger than 6 mo of
age who present with fever and seizure.
● A low sodium level is associated with higher risk of recurrence of the febrile
seizure within the following 24 hr.
● Blood studies (serum electrolytes, calcium, phosphorus, magnesium,
● and complete blood count) and EEG and CT or MRI is not recommended

8. Management and Treatment
In general no need for treatment , justeducation of how to
handle and risk of reccurnce