Recommendations

The Australia and New Zealand Child Neurology Society

1.
Do not routinely perform electroencephalographs (EEGs) for children presenting with febrile seizures.

Febrile seizures are seizures associated with fever, but without evidence of central nervous system infection. There is no evidence that epileptiform discharges (i.e. distinctive electroencephalograph patterns associated with epileptic disorders) in children with febrile seizures have any diagnostic or prognostic implications.

For instance, even among otherwise neurodevelopmentally normal children with a first complex febrile seizure (febrile seizures which are prolonged or occur multiple times within 24 hours or are confined to one side of the body) these EEG patterns are a poor predictor for epilepsy. Therefore, an EEG test should not be a routine investigation for these and other patients presenting with febrile seizures.

Supporting evidence
  • Harini C, Nagarajan E, Kimia AA, et al. Utility of initial EEG in first complex febrile seizure. Epilepsy Behav 2015; 52(Pt A):200-4.
  • Kuturec M, Emoto SE, Sofijanov N, et al. Febrile seizures: is the EEG a useful predictor of recurrences? Clin Pediatr (Phila) 1997; 36(1):31-6.
  • Sadleir LG, Scheffer IE. Febrile seizures. BMJ 2007; 334(7588):307-11.
  • Shah PB, James S, Elayaraja S. EEG for children with complex febrile seizures. Cochrane Database Syst Rev 2015; 8(12):CD009196.