ED and Inpatient Pathway for the Evaluation/Treatment of the Child with Febrile Seizures without Neurologic Disease
  • Concerning Features
  • Focality or Todd’s paralysis lasting > 15 min
  • ≥ 4 seizures in 24 hours
  • Duration > 15 minutes
  • Duration > 5 min +
    benzodiazepine
  • Failure to return to baseline mental status
  • Significant developmental delay
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Assess for meningitis/intracranial/head or neck infection
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  • Care is guided by History and Physical Examination to identify fever source and concerning features.
  • Routine lab tests are not recommended for simple febrile seizures or complex febrile seizures without concerning features.
  • Laboratory testing should focus on age appropriate fever evaluation guided by H&P.
  • AAP Guidelines for Febrile Seizures +
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ED Evaluation
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Posted: June 2016
Reviewed: October 2018
Authors: J. Hart, MD; M. Blackstone, MD; K. Dorland, RN; D. Bearden, MD; M. Sergonis, MD; V. Scheid, MD;
T. Kaur, MD; S. Haas, MD; and L. Adang, MD