Exams and Tests

In evaluating a child with a febrile seizure, the physician is concerned about stopping the current seizure activity and then finding the causes of the seizures and the fever.

• Once seizure activity has stopped and the child’s condition is stabilized, attention turns toward determining the cause of the seizure. The doctor will want to know this type of information:
  
  
  • Previous seizures without a fever (if so, then it is more likely the child has an underlying seizure disorder, such as epilepsy, rather than a febrile seizure)
    
    
  • Family history of seizures, febrile or otherwise
    
    
  • Presence of any known nervous system disorders in the child, such as delay in development or severe head injury
    
    
  • Any medications the child has been taking, including the possibility of poisoning
  
  
• The doctor will conduct a careful physical examination to detect any nervous system disorders.
  
  
• The physician will also try to determine the cause of the fever. In particular, meningitis may be a possibility, especially in a child with any of the following characteristics:
  
  
  • Younger than 12 months
    
    
  • Appears particularly ill
    
    
  • Stiffness of the neck (for example, difficulty flexing chin toward the chest)
    
    
  • Unusually long period of drowsiness after the seizure
    
    
  • Experiencing complex febrile seizure (often prolonged or repeated seizures)
  
  
• Other tests, such as blood and urine tests, and x-rays, such as a chest x-ray, may be used in diagnosing the cause of fever. However, advanced studies such as head CT scan and EEG (electroencephalogram, brain wave tracing) are unlikely to be useful and are seldom used.