Regarding febrile convulsions in children, which of the following statements is correct?

Explanation

Core Concept: Febrile Seizures. Seizures occurring in childhood (typically 6 months to 5 years) associated with a febrile illness not caused by a CNS infection. They are classified as simple (generalized, <15 mins, once in 24h) or complex (focal, >15 mins, or recurrent in 24h).

Clinical Presentation:

• Generalized tonic-clonic activity coinciding with a rapid spike in body temperature during a viral illness.
• Post-ictal state followed by a rapid return to baseline neurological status.

Diagnosis:

• First-line: Thorough history and physical examination to identify the source of fever and rule out meningitis/encephalitis.
• Gold Standard: Clinical diagnosis. EEG or neuroimaging is generally not indicated for simple febrile seizures but may be considered for complex cases or if neurological deficits are present.

Management:

• Acute: Abort prolonged seizures (>5 mins) with rectal diazepam or IV/IM lorazepam. Treat the underlying febrile illness and provide parental reassurance.
• Definitive: Antipyretics improve comfort but do NOT prevent febrile seizures. Complex febrile seizures carry a higher risk (up to 10-15%) of developing into afebrile seizures (epilepsy) later in life compared to simple febrile seizures (~2%).