What advice should I provide to parents regarding the risk of future seizures in children who have experienced a febrile seizure?

Advice to parents regarding the risk of future seizures after a febrile seizure:

• Febrile seizures are generally benign and are not the same as epilepsy; the risk of developing epilepsy after a febrile seizure is low.
• Most febrile seizures are short-lasting, typically stopping within 2 to 3 minutes without treatment, and are not harmful to the child.
• About one in three children who have had a febrile seizure will experience another febrile seizure.
• The risk of febrile seizures decreases as the child’s brain matures and they are rare beyond 6 years of age.
• Not all febrile illnesses or episodes of fever will provoke a febrile seizure.
• Parents should be educated on first aid management of seizures, including protecting the child from injury, timing the seizure, and placing the child in the recovery position once the seizure stops.
• Parents should be advised on when to seek emergency help, such as if the seizure lasts more than 5 minutes or if there are signs of serious illness.
• Routine use of prophylactic antipyretics (paracetamol or ibuprofen) to prevent febrile seizures is not recommended, nor is the routine prescription of antiepileptic drugs after a febrile seizure unless advised by a specialist.
• Parents should ensure the child completes all childhood immunisations, even if a febrile seizure followed a vaccination, and prophylactic antipyretics before vaccination are not recommended.
• Written information and support resources should be provided to parents to help manage future febrile illnesses and seizures.

These points help reduce parental anxiety and promote appropriate care and safety for the child.

References: All points are based on UK clinical guidelines and expert consensus on febrile seizures ¹.