The Croatian Society of pediatric neurology guidelines for the diagnosis and therapy of febrile seizures

Abstract

Febrile seizures are occasional cerebral seizures that occur in 2%-5% of children aged 6-60 months. Despite progress in the understanding of febrile seizures pathophysiology and the development of its guidelines, there are still many variations in the interpretation of these guidelines and in the evaluation and treatment of children with febrile seizures in the Republic of Croatia. Therefore, the Croatian Society of Pediatric Neurology developed the guidelines for the rational diagnosis and therapy of febrile convulsions, which should be feasible in all hospitals in the Republic of Croatia. The purpose of these guidelines is to assist in making rational decisions for diagnosis and treatment and they do not represent the only possible protocol for all patients with this disorder. An additional specific objective is to emphasize the medical evidence based approach to the risk and benefit of continuous and intermittent prophylactic antiepileptic therapy, as well as to the use of antipyretics in children with febrile seizures. Despite the high prevalence and percentage of relapses of febrile seizures, long lasting effects are not known nor scientifically proven in the literature. The risk of developing epilepsy in these patients is low, although slightly higher than in the general population. There is no evidence that the prophylactic use of antiepileptic drugs in children with simple febrile seizures can reduce the incidence of epilepsy. There is no evidence that the use of intermittent diazepam prophylaxis of simple febrile seizures is rational and reasonable. Continuous prophylaxis with antiepileptic drugs or intermittent diazepam therapy may reduce the incidence of recurrent febrile seizures. However, the risk of side effects and potential toxicity of antiepileptic drugs beyond the already low risk of complications in children with simple febrile seizures does not recommend continuous or intermittent therapy with antiepileptic drugs in children with simple febrile seizures. Antipyretics have not been shown to be effective in preventing recurrence of febrile seizures.