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Febrile seizure — USMLE Step 3 MCQ

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HardPediatrics (well-child, chronic management)Febrile seizureUSMLE Step 3

An 18-month-old has a generalized seizure lasting two minutes during a febrile viral illness and returns rapidly to baseline. Examination is normal with no meningismus or focal deficit. What is the best next step?

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Correct answer: E — Evaluate the fever source and provide guidance without routine EEG or imaging

This is a simple febrile seizure. The focus is the cause of fever and parental guidance; routine EEG, neuroimaging, and chronic antiseizure therapy are not indicated in a neurologically normal child.

Reference: American Academy of Pediatrics, Febrile Seizures Guideline: https://publications.aap.org/pediatrics/article/127/2/389/64951/Neurodiagnostic-Evaluation-of-the-Child-With-a