Febrile seizures From molecular biology to clinical practice

Febrile seizures occur between the age of 3 months and 5 years with a temperature of 38°C or higher, and are eithersimple or complex. Eight gene loci have been identified to be associated with certain cases of autosomal dominantfamilial febrile seizures, and 12 genes have been associated with some of the familial epilepsy syndromes that can startwith febrile seizures. The mutations and the protein products are known for only some of these 20 genes. The risk ofrecurrence of convulsions in a further febrile illness is on average 30%, and of developing epilepsy is on average 6%,but both vary depending on the presence and number of risk factors in any given patient. The immediate treatment of afebrile convulsion is intravenous or rectal diazepam, but febrile status epilepticus requires intravenous Phenobarbitaland possibly other medications. Long-term antiepileptic drugs are not recommended in most patients with febrileseizures. However, exceptions should be considered on an individual basis in patients with complex febrile seizureswith multiple risk factors for development of later epilepsy.