Diagnostic testing (EEG, MRI, CSF studies) in Complex Febrile Seizures: when and why, and are they overdone?

ICNC2024
The Tangled Web of Complex Febrile Seizures: A Common But Complex Conundrum

Diagnostic testing (EEG, MRI, CSF studies) in Complex Febrile Seizures: when and why, and are they overdone?
Puneet Jain

Children who experience simple febrile seizure and are well-appearing do not require routine diagnostic testing. However, the decision-making is unclear for complex febrile seizures. Pediatricians and neurologists are frequently in a dilemma regarding the extent of investigations indicated in children with complex febrile seizures. This talk will review the available literature and provide guidance in this regard, supplemented with case scenarios. Based on published literature, the yield of lumbar puncture or neuroimaging in a child with complex febrile seizures is low; however, these must be considered in presence of an abnormal neurological examination.
Recent literature on association between HHV 6 and complex febrile seizures will be discussed. EEG usually has no role in acute management of febrile seizures. However, it should be considered in children with multiple risk factors for epilepsy (e.g. developmental delay, family history). The optimal timing of the investigations is not clear, and literature regarding this will be reviewed. The talk will also focus on the need for these investigations in febrile status epilepticus. Data from FEBSTAT study will be summarized.

Other Lectures in this symposium:
Prognostication and counseling families of children with Complex Febrile seziures
Long term management : is there a right choice – no prophylaxis vs intermittent prophylaxis vs continuous prophylaxis with antiseizure medication
Definitions and terminology of complex febrile seizures - is a subclassification required