2.  Brief (<15 min), generalized, tonic- clonic seizure associated with a febrile illness, but without any CNS infection, severe metabolic disturbance, or other known neurological cause  The most common seizure disorder during childhood

3.  Age: 6 m/o ~ 5 y/o  Incidence: 2% ~ 4% in children <5 y/o  Peak age of onset: 18 ~ 22 m/o  Sex: male = female  Strong family history in siblings and parents: increase risk 2~3 times

4.  Viral URI  Reseola  Acute otitis media

5.  80~90% of cases  Occur early when core temperature reaches 39 C or greater  Generalized, tonic-clonic for seconds to 15-min, followed by a postictal period of drowsiness

6.  Age 5 y/o  Onset >24 hr after fever onset  Duration >15 min  Occur more than once in 24 hr  Focal motor manifestations  Abnormal neurological examination

7.  Typical: not required  Atypical: required EEG Toxicology screening Assessment of electrolytes CT or MRI

8.  Routine treatment: Search for the cause of fever Control fever (avoid excessive clothing, encourage fluids, tepid sponge bath, and antipyretics)  Prophylactic anticonvulsants are not indicated for typical febrile convulsion

9.  Excellent prognosis in most children  Risk of recurrence: Onset < 1 y/o or with family history: 50% Onset > 1 y/o: 30 % up to the age of 5 yr After second episode: 50 % Age > 5 y/o: near zero

10.  Risk of epilepsy development: 1~2% in the general population increase up to 9% when two or more risk factors are present

11.  Risk factors for epilepsy development: Positive family history of epilepsy Atypical febrile convulsion Previous abnormal development or neurological disorder

12.  Antipyretic agents: ineffective  Diazepam: effective and safe Oral or rectal form For patients with frequent febrile convulsion or significant parental anxiety Dose: 0.3 mg/kg q8h PO (1 mg/kg/d) for the duration of the illness (2~3 days) Side effects: lethargy, irritable, ataxia

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