Cause of Fever in Febrile Seizures Needs to Be Identified

New guidelines stress importance of finding cause of fever, use of interventions when necessary

WEDNESDAY, Feb. 2 (HealthDay News) -- Clinicians evaluating infants or young children following a simple febrile seizure should focus on identifying the cause of the fever, according to new guidelines published in the February issue of Pediatrics.

Patricia K. Duffner, M.D., from the American Academy of Pediatrics (AAP) Subcommittee on Febrile Seizures, and colleagues conducted a review and analysis of the medical literature on febrile seizures published since the last AAP practice guidelines were published in 1996 through 2009. Committee members focused on interventions, including lumbar puncture, electroencephalography, blood studies, and neuroimaging. The strength of evidence supporting each recommendation was assessed.

The researchers set forth guidelines advising that clinicians should try to identify the cause of simple febrile seizures. For any febrile child, meningitis should be considered in the differential diagnosis, and lumbar puncture performed if indicated by the clinical signs or symptoms. An infant aged 6 to 12 months presenting with both a seizure and a fever should undergo a lumbar puncture if the immunization status cannot be confirmed, or is deficient, due to an increase in the of risk of bacterial meningitis. Lumbar puncture is an option for those children who have already been treated with antibiotics. Usually, a simple febrile seizure does not necessitate further evaluation such as electroencephalography, blood studies, or neuroimaging.

"Clinicians evaluating infants or young children after a simple febrile seizure should direct their attention toward identifying the cause of the child's fever," the authors write.

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