Question

A 2-year-old child presents to the emergency department with a generalized tonic-clonic seizure lasting 3 minutes associated with high fever \(39.5^\circ C\). The child has no previous seizure history or neurological problems. The seizure has now stopped, but parents are concerned about recurrence. What is the most appropriate immediate management for this febrile seizure?

• A. Ethosuximide
• B. Sodium valproate
• C. Diazepam
• D. No antiepileptic medication needed

Hint:

Acute febrile seizure control is done with a benzodiazepine, commonly diazepam.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
The question describes a "Simple Febrile Seizure" and asks for the management to address the acute situation and parental concerns.
Step 2: Detailed Explanation:

Definition of Simple Febrile Seizure: Generalized, shorter than 15 minutes, and occurs once in a 24-hour period in a child aged 6 months to 5 years.

Acute Management: If a child is actively seizing in the ED, a benzodiazepine like Diazepam (Midazolam or Lorazepam are also first-line) is given to terminate the seizure.

Intermittent Prophylaxis: For parents concerned about recurrence during the same febrile episode or future ones, "intermittent prophylaxis" is often recommended. This involves giving oral or rectal Diazepam only at the onset of a fever.

Long-term Treatment: Long-term antiepileptics (Valproate, Phenobarbital) are NOT recommended for simple febrile seizures because the risks (side effects) far outweigh the benefits (the condition is benign).
- Option D: While technically correct for long-term care, Diazepam is the clinical drug of choice for management in the acute/recurrent window as a rescue measure.

Step 3: Final Answer:
Based on clinical management standards for providing rescue medication, Diazepam is the appropriate pharmacological intervention.