AccScience Publishing / ITPS / Volume 7 / Issue 2 / DOI: 10.36922/itps.2735

Progression of pediatric febrile seizure to status epilepticus: A case report

Mohammed Misbah Ul Haq1* Safa Hussain1 Yaseen Farha1 Swetha Parupugalla2
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1 Department of Pharmacy Practice, Deccan School of Pharmacy, Hyderabad, Telangana, India
2 Department of Pharmacy Practice, Bharat Institute of Technology, Hyderabad, Telangana, India
INNOSC Theranostics and Pharmacological Sciences 2024, 7(2), 2735
Submitted: 14 January 2024 | Accepted: 26 March 2024 | Published: 26 April 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( )

Managing pediatric febrile seizures progressing into status epilepticus (SE) presents challenges due to diagnostic complexities and the evolving nature of symptoms. This case report presents the management of a 1-year-old pediatric patient who experienced a febrile seizure progressing into SE. Laboratory findings reflected common variations observed in febrile illnesses and seizures. Treatment comprised a multidrug regimen involving antibiotics, anticonvulsants, and supportive care, primarily focused on seizure control, infection management, and symptomatic relief, aligning with established protocols for SE management in pediatric patients. However, the potential for drug interactions, particularly with carbapenems, underscores the importance of medication selection, especially in patients predisposed to seizures or neurological complications. This case report emphasizes the necessity for a multidisciplinary approach involving pediatricians, neurologists, and clinical pharmacists in optimizing treatment strategies for SE. The involvement of clinical pharmacists in medication review, dosage adjustments, monitoring for drug interactions, and patient education played a pivotal role in achieving positive outcomes in this critical scenario. This report sheds light on the complexities and challenges inherent in managing pediatric febrile seizures advancing to SE and underscores the significance of collaborative, multidisciplinary care in such cases.

Febrile status epilepticus
Pediatric seizures
Multi-drug regimen
Neurological complications
  1. Leung AK, Hon KL, Leung TN. Febrile seizures: An overview. Drugs Context. 2018;7:212536. doi: 10.7573/dic.212536


  1. Batra P, Thakur N, Mahajan P, et al. An evidence-based approach to evaluation and management of the febrile child in Indian emergency department. Int J Crit Illn Inj Sci. 2018;8(2):63-72. doi: 10.4103/IJCIIS.IJCIIS_3_18


  1. Pavone P, Corsello G, Ruggieri M, Marino S, Marino S, Falsaperla R. Benign and severe early-life seizures: A round in the first year of life. Ital J Pediatr. 2018;44(1):54. doi: 10.1186/s13052-018-0491-z


  1. Auvin S, Antonios M, Benoist G, et al. Évaluation d’un enfant après une crise fébrile: Focus sur trois problèmes de pratique clinique [Evaluating a child after a febrile seizure: Insights on three important issues]. Arch Pediatr. 2017;24(11):1137-1146. doi: 10.1016/j.arcped.2017.08.018


  1. Kwon A, Kwak BO, Kim K, et al. Cytokine levels in febrile seizure patients: A systematic review and meta-analysis. Seizure. 2018;59:5-10. doi: 10.1016/j.seizure.2018.04.023


  1. Guedj R, Chappuy H, Titomanlio L, et al. Do all children who present with a complex febrile seizure need a lumbar puncture? Ann Emerg Med. 2017;70(1):52-62.e6. doi: 10.1016/j.annemergmed.2016.11.024


  1. Renda R, Yüksel D, Gürer YKY. Evaluation of patients with febrile seizure: Risk factors, reccurence, treatment and prognosis. Pediatr Emerg Care. 2020;36(4):173-177. doi: 10.1097/PEC.0000000000001173


  1. Printz V, Hobbs AM, Teuten P, Paul SP. Clinical update: Assessment and management of febrile children. Community Pract. 2016;89(6):32-37.


  1. Rasmussen NH, Noiesen E. Foraeldre til børn med feberkramper. Tvaerfaglig kvalitetsudvikling af information og dokumentation [Parents of children with febrile convulsions. Multidisciplinary quality development of information and documentation]. Ugeskr Laeger. 2001;163(8):1103-1106.


  1. Sperling MR, Bucurescu G, Kim B. Epilepsy management. Issues in medical and surgical treatment. Postgrad Med. 1997;102(1):102-104. doi: 10.3810/pgm.1997.07.251


  1. Lee J, DeLaroche AM, Janke AT, Kannikeswaran N, Levy PD. Complex febrile seizures, lumbar puncture, and central nervous system infections: A national perspective. Acad Emerg Med. 2018;25(11):1242-1250. doi: 10.1111/acem.13441


  1. Offringa M, Newton R, Cozijnsen MA, Nevitt SJ. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2017;2(2):CD003031. doi: 10.1002/14651858.CD003031.pub3


  1. Subcommittee on Febrile Seizures, American Academy of Pediatrics. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011;127(2):389-394. doi: 10.1542/peds.2010-3318c


  1. Chang BS, Lowenstein DH. Epilepsy. N Engl J Med. 2003;349(13):1257-1266. doi: 10.1056/NEJMra022308


  1. Santoro B, Lee JY, Englot DJ, et al. Increased seizure severity and seizure-related death in mice lacking HCN1 channels. Epilepsia. 2010;51(8):1624-1627. doi: 10.1111/j.1528-1167.2010.02554.x


  1. Marini C, Porro A, Rastetter A, et al. HCN1 mutation spectrum: From neonatal epileptic encephalopathy to benign generalized epilepsy and beyond. Brain. 2018;141(11):3160-3178. doi: 10.1093/brain/awy263


  1. Millar JS. Evaluation and treatment of the child with febrile seizure. Am Fam Physician. 2006;73(10):1761-1764.


  1. Nakamura Y, Shi X, Numata T, et al. Novel HCN2 mutation contributes to febrile seizures by shifting the channel’s kinetics in a temperature-dependent manner. PLoS One. 2013;8(12):e80376. doi: 10.1371/journal.pone.0080376


  1. Dibbens LM, Reid CA, Hodgson B, et al. Augmented currents of an HCN2 variant in patients with febrile seizure syndromes. Ann Neurol. 2010;67(4):542-546. doi: 10.1002/ana.21909


  1. Chamberlain JM, Okada P, Holsti M, et al. Lorazepam vs diazepam for pediatric status epilepticus: A randomized clinical trial. JAMA. 2014;311(16):1652-1660. doi: 10.1001/jama.2014.2625


  1. McIntyre J, Robertson S, Norris E, et al. Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: A randomised controlled trial. Lancet. 2005;366(9481):205-210. doi: 10.1016/S0140-6736(05)66909-7


  1. Murata S, Okasora K, Tanabe T, et al. Acetaminophen and febrile seizure recurrences during the same fever episode. Pediatrics. 2018;142(5):e20181009. doi: 10.1542/peds.2018-1009


  1. Steering Committee on Quality Improvement and Management, Subcommittee on Febrile Seizures American Academy of Pediatrics. 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


  1. Offringa M, Newton R. Prophylactic drug management for febrile seizures in children (Review). Evid Based Child Health. 2013;8(4):1376-1485. doi: 10.1002/ebch.1921


  1. Koe AS, Jones NC, Salzberg MR. Early life stress as an influence on limbic epilepsy: An hypothesis whose time has come? Front Behav Neurosci. 2009;3:24. doi: 10.3389/neuro.08.024.2009
Conflict of interest
The authors declare that they have no conflict of interest.
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INNOSC Theranostics and Pharmacological Sciences, Electronic ISSN: 2705-0823 Published by AccScience Publishing