Contact Maureen McArthur

~

"Seizures are frightening events, especially for parents who see their toddler have a generalized seizure with jerking of the limbs and foaming from the mouth. Parents have a natural tendency to assume the worst and may push physicians to do extensive testing and place the child on medication."

- Robert J. Baumann, M.D., professor, Departments of Neurology and Pediatrics, University of Kentucky College of Medicine

For more information, see the technical report.

~

Robert J. Baumann, M.D., professor, Departments of Neurology and Pediatrics, University of Kentucky College of Medicine, and member of the American Academy of Pediatrics (AAP) Committee on Quality Improvement, Subcommittee on Febrile Seizures, wrote the technical report, "Treatment of the Child with Simple Febrile Seizures," published in the June issue of Pediatrics, which provides detailed information on the studies used to form this recommendation by the AAP.

A simple febrile seizure is a brief (less than 15 minutes), generalized (indicated by symmetrical movements of both sides of the body) seizure in a child 6 months to 5 years old following a rapid increase in body temperature. The recommendations are not intended to apply to children who have meningitis or encephalitis at the time of the seizure.

"Seizures are frightening events, especially for parents who see their toddler have a generalized seizure with jerking of the limbs and foaming from the mouth," Baumann said. "Parents have a natural tendency to assume the worst and may push physicians to do extensive testing and place the child on medication."

Children younger than the age of 1 at the time of their first simple febrile seizure have about a 50 percent chance of having another. Children older than the age of 1 at the time of their first seizure have about a 30 percent chance of a second seizure. Of those that do have a second seizure, 50 percent have a chance of having yet another.

However, this extensive review and an earlier one published in the May 1996 issue of Pediatrics, entitled "Practice Parameter: The Neurodiagnostic Evaluation of the Child with a First Simple Febrile Seizure," indicate that a simple febrile seizure is not a harbinger of a life long disability, does not merit conducting extensive testing on the child such as imaging of the brain, and is not an indicator that the child requires anticonvulsant medication.

It is possible to prevent future simple febrile seizures by giving the child daily anticonvulsant medication, Baumann said.

However, like all medications, anticonvulsants have potential side effects, and the potential problems due to side effects exceed any benefit that anticonvulsants could have. There is no evidence that taking anticonvulsants, such as phenobarbital or valproate, every day will improve a child’s health or will prevent epilepsy later in life.

In determining its findings, the AAP reviewed more than 300 medical journal articles on simple febrile seizures.

"We hope to save young children from unnecessary testing and drug therapy," Baumann said. "While we are eager that any child who has seizures that require daily anticonvulsant therapy receive that therapy, we also are eager that no child be given anticonvulsants or other medications unnecessarily."