Febrile Seizures Treatment & Management

Updated: Dec 11, 2018
  • Author: Nooruddin R Tejani, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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Prehospital Care

See the list below:

  • Patients with active seizures should be treated with airway management, high-flow oxygen, supportive care, and anticonvulsants as necessary. Acute treatment such as rectal diazepam (0.5 mg/kg) and buccal 0.4-0.5 mg/kg) or intranasal (0.2 mg/kg) are effective and can be given at home for a seizure lasting longer than 5 minutes. [43, 44, 45]

  • Patients who are postictal should receive supportive care and antipyretics as appropriate.


Emergency Department Care

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  • Patients presenting with status epilepticus should be treated with airway management and anticonvulsants as necessary.

  • Patients presenting with history and physical examination findings consistent with a simple febrile seizure should have frequent neurologic examinations to monitor mental status.

  • Other causes of seizure should be ruled out.

  • The cause of the febrile illness should be sought and treated.

  • Antipyretics should be considered. Acetaminophen (Tylenol) and ibuprofen (Motrin) are often used.

    • A randomized controlled trial published in 2018 suggested that rectal acetaminophen 10 mg/kg given every 6 hours may prevent febrile seizure recurrence within the same febrile episode. [46]

  • Parental anxiety and fear that their child may die or will develop brain damage needs to be addressed with reassurance and education.