title: Febrile seizures: emergency medicine perspective.
abstract: OBJECTIVE
  The review describes current evidence on the evaluation of febrile seizures in the acute setting, the need for further outpatient assessment, and predictors regarding long-term outcomes of these patients.
  
  
  RESULTS
  New evidence has been added in support of limited assessment and intervention: evidence on low utility of lumbar puncture, emergent neuroimaging, and follow-up electroencephalography, as well as low yield for antipyretic prophylaxis and intermittent use of antiepileptic drugs. Finally, there is growing evidence regarding the genetic basis of both febrile seizures and vaccine-related seizures/febrile seizures.
  
  
  CONCLUSIONS
  Routine diagnostic testing for simple febrile seizures is being discouraged, and clear evidence-based guidelines regarding complex febrile seizures are lacking. Thus, clinical acumen remains the most important tool for identifying children with seizures who are candidates for a more elaborate diagnostic evaluation. Similarly, evidence and guidelines regarding candidates for an emergent out-of-hospital diazepam treatment are lacking.
authors.affiliation: aDivision of Emergency Medicine, Boston Children's Hospital bPediatric Neurology, Boston Medical Center cDivision of Emergency Medicine, Pediatric Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Amir A
authors.initials: AA
authors.lastname: Kimia
authors.forename: Richard G
authors.initials: RG
authors.lastname: Bachur
authors.forename: Alcy
authors.initials: A
authors.lastname: Torres
authors.forename: Marvin B
authors.initials: MB
authors.lastname: Harper
mesh_terms: D026683:Advisory Committees; D000927:Anticonvulsants / Q000627:therapeutic use*; D058633:Antipyretics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D004635:Emergency Medicine / Q000379:methods*; D020022:Genetic Predisposition to Disease; D006801:Humans; D059906:Neuroimaging / Q000379:methods*; D017410:Practice Guidelines as Topic; D003294:Seizures, Febrile / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D013129:Spinal Puncture / Q000379:methods*
chemical_list: D000927:Anticonvulsants; D058633:Antipyretics