Treatment of Febrile Seizures in a Child Aged Under 3 Years
Clinical Scenario
This protocol applies to febrile seizures occurring in children aged under 3 years — an age group for which specific therapeutic preferences guide agent and route selection.
Treatment Approach
Acute management centres on rescue therapy with a benzodiazepine to achieve rapid seizure termination. The choice of agent and route is age-specific in this population. The complete protocol — covering agent selection, administration, and escalation steps — is available in full behind the link below.
Clinical Goals
- Termination of the febrile seizure
- Reassessment at 5 minutes after the first dose
References
DOI: 10.1186/s13052-024-01666-1
The recommendation is to prefer rectal DZP for children aged less than 3 years (at a dose of 5 mg) with a subsequent switch to buccal MDZ.
With this in mind, buccal midazolam (MDZ) and rectal diazepam (DZP) are the first choice as rescue therapy.
Consequently, seizures lasting longer than five minutes are improbable to cease on their own, and the administration of a benzodiazepine (BDZ) is recommended to terminate the seizure.
After a first dose of BDZ, a second one could be administered after 5 min if the FS has not stopped.
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