Febrile Seizures without Neurologic Disease — Admission Considerations — Clinical Pathway: Emergency Department, Inpatient, Outpatient Specialty Care and Primary Care

Febrile Seizures without Neurologic Disease Clinical Pathway — Emergency Department, Inpatient, Outpatient Specialty Care and Primary Care

Admission Considerations

Admission Criteria/Service

General Pediatrics Neurology PICU
  • Fever source requires admission
  • Febrile seizures that require further observation
  • Need for long-term EEG monitoring
  • Children treated for febrile status epilepticus, now resolved
 Child requires ICU level of monitoring and care

Inpatient Evaluation

Evaluation Indication
Laboratory Testing Focus on age-appropriate fever evaluation guided by history and physical exam
Lumbar Puncture Consider if concern for intracranial infection
Inpatient Imaging
  • Consider MRI
    • Persistent focal deficit
    • Mental status not returning to baseline
EEG Long-term Monitoring
Inpatient routine EEG not recommended		 Mental status not returning to baseline
Neurology Consult
  • Prolonged post-ictal focal deficits, including suspected Todd’s paralysis, > 15 mins
  • Hemiclonic seizures: focal rhythmic jerking that do not secondarily generalize
  • Seizure > 15 mins or treated acutely prior to 15 min
  • Failure to return to baseline mental status
  • ≥ 3 febrile seizures in < 24 hrs