Given that febrile seizures (FSs) are the most common seizure "syndrome" of childhood occurring in 2 to 4 percent of individuals, one would think that clear definitions and descriptors based upon data are available. However, when one digs not very far below the surface, one finds some fundamental gaps. In 1980, the National Institutes of Health (1) convened a consensus conference to approach a number of critical questions such as, "What is a febrile seizure?"as well as attendant risks (injury, repeat febrile and afebrile seizures, benefits and risks of prophylaxis and management). The consensus suggested that these seizures usually occurred between 3 months and 5 years, but otherwise did not provide guidance as to how long the seizures last or any basis for distinguishing those that were prolonged from those that were not. However, a prolonged seizure was identified as one of the important risk factors predisposing the child to afebrile seizures. One of the seminal studies upon which this recommendation was based (and which we have used to counsel our families) defined prolonged as greater than 15 minutes and reported that this will occur in almost 8 percent of children with FS (2). The use of 10 to 15 minutes as the cut-point to identify seizures as prolonged has been adopted by subsequent reports (3-6).
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