Febrile Seizures: A Systematic Review of Different Guidelines

Background Febrile seizures (FS) are the most common neurological disorder in pediatric age. They affect 2-12% of children and result from a complex interplay of genetic and environmental factors. Effective management and unambiguous recommendations are crucial for allocating healthcare resources efficiently and ensuring cost-effectiveness in treating FS. Methods This systematic review compares existing guidelines to provide insights into FS management. Seven guidelines published between 1991 and 2021, from Japan, United Kingdom, United States, Mexico, India and Italy, were included. Data extraction covered definitions, diagnostic criteria, hospital admission criteria, diagnostic tests, management and prophylaxis recommendations. Results Hospital admission criteria varied but typically included age < 18 months and complex FS. Neuroimaging and lumbar puncture recommendations varied, with most guidelines suggesting limited use. Pharmacological prophylaxis was generally discouraged for simple FS but considered only for high-risk cases, due to the benign nature of FS and potential side effects of antiseizure medications. Conclusion Guidelines on FS exhibit similarities and differences, highlighting the need for standardized management and improved parental education to enhance clinical outcomes and reduce economic and social costs associated with FS. Future research should focus on creating updated international guidelines and ensuring their practical implementation.