What is a Febrile Seizure(FS)?
A febrile seizure is a seizure accompanied by fever (usually > 38C) without CNS (Central Nervous System) infection in infants and children 3 months to 5 years of age. Those with pre existing neuro developmental abnormalities are more vulnerable. Boys are more affected than girls. Febrile Seizures usually manifests during first day of acute infection.

What factors predispose a child to febrile seizures?
* High degree of fever at initial presentation.
* History of febrile seizure in the family
* Delayed developmental milestones
* Infections commonly found in children with Febrile Seizures
   - Otits media (ear infection)
   - Upper respiratory infections
   - Urinary tract infections
   - Gastro intestinal infections.
* Convulsions with fever in neurological conditions like
   - Meningoencephalitis
   - CNS tumours
   - Electrolyte imbalance etc. ARE NOT Febrile Seizures.

Types of Febrile Seizures
Simple / Typical (85%)
Complex / Atypical (15%)
   - partial onset
   - prolonged duration > 15 mins
   - multiple in a 24 hour period

Indications for Intermittent Diazepam prophylaxis during febrile illness
* Children with prolonged Febrile Seizures
* Children with multiple recurrences
* Children with risk factors for recurrences i.e.
   - Age < 1 year at seizure onset
   - Positive family history of Febrile Seizures
   - Low temperature at onset of seizure
   - Shorter duration of temperature before Febrile Seizures
Dose : 0.3 mg/kg/dose

Home Management of febrile seizures by parents
* Turn child to semiprone position to prevent aspiration of vomitus.
* Administer per rectal diazepam (diluted intravenous preparation 2.5mg for children < 1 year, 5 mg for older children given through a feeding tube inserted 4 - 5cms into the rectum after lubrication with petroleum jelly).
* Summon medical help if seizure does not subside / occurs.

Risk of subsequent epilepsy
The overall risk of epilepsy after Febrile Seizures is 2%. The risk factors for epilepsy are
* Complex febrile seizures
* Developmental / neurologic abnormality present before 1st seizure
* Non febrile seizures in parents / siblings