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Febrile seizures and status epilepticus are medical emergencies requiring prompt recognition and management. However, febrile seizures are ultimately benign in most children and rarely require chronic anticonvulsants due to side effects.

Pharmacists should be prepared to assist in risk stratification, administration of emergency anticonvulsants, and prevention of medication errors. For status epilepticus, priority is terminating seizures quickly with benzodiazepines while identifying the underlying etiology. Multimodal management and aggressive support are crucial in refractory cases to avoid permanent neurological injury.

References

  1. Febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics. 2008;121(6):1281-1286. doi:10.1542/peds.2008-0939
  2. Raspall-Chaure M, Chin RF, Neville BG, Bedford H, Scott RC. The epidemiology of convulsive status epilepticus in children: a critical review. Epilepsia. 2007;48(9):1652-1663. doi:10.1111/j.1528-1167.2007.01120.x
  3. Glauser T, Shinnar S, Gloss D, et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline committee of the American Epilepsy Society. Epilepsy Curr. 2016;16(1):48-61. doi:10.5698/1535-7511-16.1.48
  4. Patel N, Ram D, Swiderska N, et al. Febrile seizures. BMJ. 2015;351:h4240. doi:10.1136/bmj.h4240
  5. Graves RC, Oehler K, Tingle LE. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician. 2012;85(2):149-153.
  6. Patel AD, Vidaurre J. Complex febrile seizures: a practical guide to evaluation and treatment. J Child Neurol. 2013;28(6):762-767. doi:10.1177/0883073812457656
  7. Lyttle MD, Rainford NEA, Gamble C, Messahel S, Humphreys A, Hickey H, et al. Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial [published correction appears in Lancet. 2019 Aug 24;394(10201):746]. Lancet. 2019;393(10186):2135-2145. doi:10.1016/S0140-6736(19)30722-9