Diagnosis of Febrile Seizures
The diagnosis of febrile seizures is mainly clinical, based on a clear history of seizure activity during a fever in a child between six months and five years old. Febrile seizures are usually diagnosed by a general practitioner, paediatrician, or emergency room doctor after careful examination and observation.
Medical History and Observation
Doctors ask detailed questions, including:
Child’s age at the time of the seizure
Duration and nature of the seizure (generalised or focal)
Presence of fever before or during the seizure
Whether it was the first seizure episode
Family history of febrile seizures or epilepsy
They will also check:
If the child regained consciousness quickly
Whether the seizure recurred within 24 hours
Signs of a current or recent infection
If the seizure fits the pattern of a simple febrile seizure, no further investigations are typically required.
Physical Examination
The doctor will examine:
Temperature and vital signs
Neck stiffness or rash (to rule out meningitis)
Ear, throat, and chest for signs of infection
Neurological responses (reflexes, eye tracking, responsiveness)
A normal exam with signs of a viral illness supports the diagnosis of febrile seizures.
When Tests Are Needed
Further testing may be recommended if:
The child is younger than six months or older than five years
The seizure lasted more than 15 minutes
There were multiple seizures in one day
The child had focal (one-sided) movements
The child did not recover consciousness promptly
These cases are classified as complex febrile seizures, and further evaluation is needed.
Tests may include:
Blood and urine tests, to check for infection or metabolic imbalances
Lumbar puncture, if meningitis or encephalitis is suspected (especially in infants)
Electroencephalogram (EEG), if epilepsy is a concern
CT or MRI scan, in rare cases, to rule out structural brain problems
Differential Diagnosis
Doctors must rule out:
Meningitis or brain infection
Epilepsy, if seizures occur without fever or continue after age 6
Breath-holding spells, fainting, or other non-epileptic events
A thorough history and examination are usually enough to make a confident diagnosis.
Diagnosis of Febrile Seizures
The diagnosis of febrile seizures is mostly straightforward. For typical cases, reassurance and fever management are all that’s needed, while more complex or unusual episodes require additional assessment.
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