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Febrile seizure

  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 12 Oct 2025
Última actualización: 10 Dec 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • febrile illness
  • seizure
Todos los datos

Otros factores de diagnóstico

  • normal postictal exam
Todos los datos

Factores de riesgo

  • temperature elevation
  • young age
  • male sex
  • family history of febrile seizures
  • viral or bacterial infection outside the central nervous system
  • vaccinations
  • prenatal exposure to nicotine
  • iron deficiency
  • complications of pregnancy, labor, and delivery
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • diagnosis is clinical
Todos los datos

Tests to avoid

  • head CT
Todos los datos

Pruebas diagnósticas que deben considerarse

  • lumbar puncture
  • viral studies
  • blood culture
  • EEG
  • brain MRI
  • serum sodium
  • CBC
  • capillary blood glucose
  • serum glucose
  • iron studies
Todos los datos

Algoritmo de tratamiento

Inicial

febrile status epilepticus

Agudo

first simple febrile seizure

first complex seizure

En curso

febrile illness with prior history of simple seizure or 1 complex seizure

history of 2 or more complex febrile seizures with ineffective diazepam treatment

Colaboradores

Autores

Damian Roland, BMedSci, MBBS, FRCPCH, PhD

Honorary Professor and Consultant in Paediatric Emergency Medicine

Paediatric Emergency Medicine Leicester Academic (PEMLA) Group

Children’s Emergency Department

Leicester Royal Infirmary

Leicester

UK

Declarações

DR declares that he is a previous member of the National Institute for Health and Care Excellence Feverish Illness in Children Guideline Group.

Agradecimentos

Prof Damian Roland would like to gratefully acknowledge Dr Leena Mewasingh, Dr Frances Morrison, Dr John J. Millichap and Dr J. Gordon Millichap, previous contributors to this topic. LM has received funding from drug companies (e.g., Eisai) to attend medical conferences and been invited to an educational symposium (Novartis, LivaNova). FM declares that she has no competing interests. JJM serves as an Associate Editor of Neurology and serves on the editorial board of Pediatric Neurology Briefs; volunteers on the medical advisory board of The Jack Pribaz Foundation (KCNQ2.org); received speaker honoraria from Invitae; received royalties for online monographs from Up-To-Date; served on the scientific advisory board for Mallinckrodt; is principal investigator for a clinical trial funded by UCB Pharma; and is the principal investigator for research grants from Citizens United for Research in Epilepsy and the Thrasher Research Fund. JJM is an author of a number of references cited in this topic. JGM is an author of a number of references cited in this topic.

Revisores

Robert S. Rust, Jr., MA, MD

Professor

Department of Neurology

University of Virginia Health System

Charlottesville

VA

Declarações

RSR declares that he has no competing interests.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

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Referências

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Principais artigos

American Academy of Pediatrics: Subcommittee on Febrile Seizures. Clinical practice guideline: neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011 Feb;127(2):389-94.Texto completo  Resumo

American Academy of Pediatrics. Febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics. 2008 Jun;121(6):1281-6.Texto completo  Resumo

Millichap JG, Millichap JJ. Role of viral infections in the etiology of febrile seizures. Pediatr Neurol. 2006 Sep;35(3):165-72. Resumo

Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr. 2008 Jan;167(1):17-27. Resumo

Graves RC, Oehler K, Tingle LE. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician. 2012 Jan 15;85(2):149-53.Texto completo  Resumo

Capovilla G, Mastrangelo M, Romeo A, et al. Recommendations for the management of "febrile seizures": Ad Hoc Task Force of LICE Guidelines Commission. Epilepsia. 2009 Jan; 50(1 suppl):S2-6.Texto completo  Resumo

Natsume J, Hamano SI, Iyoda K, et al. New guidelines for management of febrile seizures in Japan. Brain Dev. 2017 Jan;39(1):2-9. Resumo

Nordli DR Jr. Idiopathic generalized epilepsies recognized by the International League Against Epilepsy. Epilepsia. 2005 Nov 18;46(9 suppl):48-56.Texto completo  Resumo

Wilmshurst JM, Gaillard WD, Vinayan KP, et al. Summary of recommendations for the management of infantile seizures: task force report for the ILAE Commission of Pediatrics. Epilepsia. 2015 Aug;56(8):1185-97.Texto completo  Resumo

Dunlop S, Taitz J. Retrospective review of the management of simple febrile convulsions at a tertiary paediatric institution. J Paediatr Child Health. 2005 Dec;41(12):647-51. Resumo

Kimia AA, Bachur RG, Torres A, et al. Febrile seizures: emergency medicine perspective. Curr Opin Pediatr. 2015 Jun;27(3):292-7. Resumo

Rosenbloom E, Finkelstein Y, Adams-Webber T, et al. Do antipyretics prevent the recurrence of febrile seizures in children? A systematic review of randomized controlled trials and meta-analysis. Eur J Paediatr Neurol. 2013 Nov;17(6):585-8. Resumo

Offringa M, Newton R, Nevitt SJ, et al. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2021 Jun 16;(6):CD003031.Texto completo  Resumo

Baumann RJ, Duffner PK; American Academy of Pediatrics. Treatment of children with simple febrile seizures: the AAP practice parameter. Pediatr Neurol. 2000 Jul;23(1):11-7. Resumo

Whelan H, Harmelink M, Chou E, et al. Complex febrile seizures: a systematic review. Dis Mon. 2017 Jan;63(1):5-23.Texto completo  Resumo

Shinnar S, Glauser TA. Febrile seizures. J Child Neurol. 2002 Jan;17(1 suppl):S44-52. Resumo

Camfield P, Camfield C. Febrile seizures and genetic epilepsy with febrile seizures plus (GEFS+). Epileptic Disord. 2015 Jun;17(2):124-33. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

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