title: Risk of intracranial pathologic conditions requiring emergency intervention after a first complex febrile seizure episode among children.
abstract: OBJECTIVE
  To determine the likelihood of intracranial pathologic conditions requiring emergency neurosurgical or medical intervention among children without meningitis who presented to the pediatric emergency department after a first complex febrile seizure.
  
  
  METHODS
  We performed a retrospective review of prospectively collected data for children in neurologically normal condition who presented to a single pediatric emergency department after a first complex febrile seizure (focal, multiple, or prolonged). The complex febrile seizure classification was determined independently by 2 epileptologists. The presence of intracranial pathologic conditions was determined through review of neuroimaging results, telephone interviews, or medical record review.
  
  
  RESULTS
  Data for 71 children with first complex febrile seizures were analyzed. Fifty-one (72%) had a single complex feature (20 focal, 22 multiple, and 9 prolonged), and 20 (28%) had multiple complex features. None of the 71 patients (1-sided 95% confidence interval: 4%) had intracranial pathologic conditions that required emergency neurosurgical or medical intervention.
  
  
  CONCLUSIONS
  For children with first complex febrile seizures, the risk of intracranial pathologic conditions that require emergency neurosurgical or medical intervention is low, which suggests that routine emergency neuroimaging for this population is unnecessary.
authors.affiliation: Department of Pediatrics, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors.forename: David
authors.initials: D
authors.lastname: Teng
authors.forename: Peter
authors.initials: P
authors.lastname: Dayan
authors.forename: Sarah
authors.initials: S
authors.lastname: Tyler
authors.forename: W Allen
authors.initials: WA
authors.lastname: Hauser
authors.forename: Stephen
authors.initials: S
authors.lastname: Chan
authors.forename: Linda
authors.initials: L
authors.lastname: Leary
authors.forename: Dale
authors.initials: D
authors.lastname: Hesdorffer
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis*; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D003294:Seizures, Febrile / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed