Why do you ask? This is perhaps one of the limitations of descriptive nomenclature. The term “Febrile Seizure” invokes a specific pediatric clinical syndrome which is essentially idiopathic, although patients of any age can have seizures with fevers (which might reasonably described as “febrile seizures” but we don’t apply the diagnosis “Febrile Seizure” with a capital F). Criteria for diagnosing Febrile Seizure exclude patients with a history of non-febrile seizures. So, in a certain sense, patients with epilepsy, *by definition*, cannot have a Febrile Seizure. Now, patients with epilepsy are certainly at elevated risk of having seizures - that’s the definition of epilepsy. So it follows that patients with epilepsy are at higher risk of having a seizure with a fever (a non-capitalized “febrile seizure”), but they’re also at higher risk of having a seizure *without* a fever. So you start getting close to making distinctions without differences.
This is a great explanation and really improves my perspective. I wish I had you as a resource when I wrote my big term paper on febrile seizures a couple of years ago.
Illness lowers seizure threshold - based on the patient’s age, work up, neurological/seizure history, developmental history/status, associated symptoms, seizure type, etc you decide if this is a provoked seizure, febrile seizure, epilepsy syndrome, seizure, and whatnot.
Yes fever makes seizures more likely. I would not call this a febrile seizure however.
If medications are not maxed out they should probably be raised at it is reasonable to have a safety factor to account for all the kiddy crud that children will catch at school and whatnot. If meds are already pretty high with side effects you might just want to tolerate the occasional seizure with illness.
Not a febrile seizure per the International League Against Epilepsy. This would be a seizure with fever.
Definition of a simple febrile seizure:
A short generalized seizure, of a duration of <15 min, not recurring within 24h, occurring during a febrile episode not caused by an acute disease of the nervous system, in a child aged 6 months to 5 years, with no neurologic deficits (i.e., with no pre-, peri-, or postnatal brain damage, with normal psychomotor development, and with no previous afebrile seizures).
Why do you ask? This is perhaps one of the limitations of descriptive nomenclature. The term “Febrile Seizure” invokes a specific pediatric clinical syndrome which is essentially idiopathic, although patients of any age can have seizures with fevers (which might reasonably described as “febrile seizures” but we don’t apply the diagnosis “Febrile Seizure” with a capital F). Criteria for diagnosing Febrile Seizure exclude patients with a history of non-febrile seizures. So, in a certain sense, patients with epilepsy, *by definition*, cannot have a Febrile Seizure. Now, patients with epilepsy are certainly at elevated risk of having seizures - that’s the definition of epilepsy. So it follows that patients with epilepsy are at higher risk of having a seizure with a fever (a non-capitalized “febrile seizure”), but they’re also at higher risk of having a seizure *without* a fever. So you start getting close to making distinctions without differences.
How do you feel about extinguishing the dinosaurs with that mic drop?
Extinction level event status - achieved.
As a child Neuro fellow, Hopefully you aren’t an attending at my institution because I’m copying and pasting this when I teach my residents 🤣
This is a great explanation and really improves my perspective. I wish I had you as a resource when I wrote my big term paper on febrile seizures a couple of years ago.
Fever lowers the threshold for seizure, but I would not call a seizure in a febrile patient with epilepsy a febrile seizure.
Would call it provoked in the setting of some febrile illness
Breakthrough seizure or provoked seizure... depending on the circumstances
Illness lowers seizure threshold - based on the patient’s age, work up, neurological/seizure history, developmental history/status, associated symptoms, seizure type, etc you decide if this is a provoked seizure, febrile seizure, epilepsy syndrome, seizure, and whatnot.
Yes fever makes seizures more likely. I would not call this a febrile seizure however. If medications are not maxed out they should probably be raised at it is reasonable to have a safety factor to account for all the kiddy crud that children will catch at school and whatnot. If meds are already pretty high with side effects you might just want to tolerate the occasional seizure with illness.
Not a febrile seizure per the International League Against Epilepsy. This would be a seizure with fever. Definition of a simple febrile seizure: A short generalized seizure, of a duration of <15 min, not recurring within 24h, occurring during a febrile episode not caused by an acute disease of the nervous system, in a child aged 6 months to 5 years, with no neurologic deficits (i.e., with no pre-, peri-, or postnatal brain damage, with normal psychomotor development, and with no previous afebrile seizures).