Choosing Wisely:

Don’t routinely order an electroencephalography on neurologically healthy children who have a simple febrile seizure.

Rationale and Comments: Febrile seizures are the most commonly occurring seizures in the first 60 months of life. Caregiver anxiety can often lead to requests for neurodiagnostic testing. Attention should be directed at finding the cause of fever and treating it. Electroencephalography tests are costly and can increase caregiver and child anxiety without changing the outcome or course of treatment. Electroencephalography has not been shown to predict recurrence of febrile seizures or future epilepsy in patients with simple febrile seizures. Electroencephalography can be ordered for children who present with afebrile seizures and complex febrile seizures, and in children with neurological insult.
Sponsoring Organizations:
  • American Academy of Nursing
  • Sources:
  • American Academy of Pediatrics guidelines
  • Disciplines:
  • Emergency medicine
  • Neurologic
  • Pediatric
  • References: • American Academy of Pediatrics Subcommittee on Febrile Seizures. (2011). Febrile seizures: guidelines for the neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics, 127 (2), 389-394.
    • El-Radhi, A., Sahib, A. (2015). Management of seizures in children. British Journal of Nursing. 24 (3), 152-155.
    • Graves, R.C., Oehler, K., Tingle, L.E. (2012) Febrile seizures: risks, evaluation, and prognosis. American Family Physician. 15(85), 149-153.
    • Harini, C., Nagarajan, E., Kimia, A., de Carvalho, R., An, S., Bergin, A., Takeoka, M., Pearl, P., Loddenkemper, T. (2015) Utility of initial EEG in first complex febrile seizure. Epilepsy and Behavior. 52 (PT A), 200-204.
    • Oluwabusi, T., Sood, S.K. (2012) Update on the management of simple febrile seizures: Emphasis on minimal intervention. Current Opinion in Pediatrics. 24 (2) 259-265.

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