Febrile Seizures.

Febrile seizures should not be treated with continuous or intermittent antiepileptic medication. Parents should be given a comprehensive explanation as to the nature of this benign disorder and potential strategies to terminate prolonged seizures or clusters of seizures. Patients with complex febrile seizures (ie, those that are prolonged, focal, recur within the same day or those which affect children with pre-existing neurologic abnormalities) should be encouraged to use rectal diazepam at the time of recurrent seizures. Chronic daily prophylaxis should be considered only in highly selected cases. There is no definitive way to distinguish the small subset of children with febrile seizures that are at an increased risk for the development of complex partial epilepsy with mesial temporal sclerosis. Complex febrile seizures, particularly focal and prolonged seizures beyond 15 minutes duration are at somewhat higher risk as demonstrated by family studies, magnetic resonance imaging (MRI) studies, and retrospective analysis of intractable complex partial epilepsy.