Criteria for admission if febrile convulsion/seizure

Majority of patients do not require hospital admission.

Admission for further assessment by a paediatrician should be considered in:

• first febrile seizure.
• decreased consciousness level before seizure (use of the Paediatric Glasgow Coma Score is encouraged for an objective record)
• slow recovery with abnormal behaviour or drowsiness after seizure - consider referral if normal neurological or mental state is not achieved within one hour
• clinical signs of meningism (irritability, neck stiffness, photophobia, headache)
• complex febrile seizures
• focal neurological deficit on examination
• unwell child with features of septicaemia
• unexplained cause of fever (1)

For children prone to recurrent febrile convulsions, parents can be provided with diazepam rectal tubes and shown how to administer them.

Reference:

• (1) Patel N et al. Febrile seizures. BMJ. 2015 ;351:h4240