A 2-year-old child has a first episode of generalized tonic-clonic seizure lasting 3 minutes during a febrile illness (temperature 39.2°C). Neurological examination is normal. There is no family history of epilepsy. What is the MOST appropriate management?

• A Start long-term anticonvulsant prophylaxis with valproate
• B Perform lumbar puncture and EEG immediately
• C Admit for 48 hours of monitoring and neuroimaging
• D Reassure parents, provide antipyretics, and educate on fever management ✓

Explanation

This is a simple febrile seizure (age 6 months-5 years, <15 minutes, generalized, no recurrence within 24 hours). It carries an excellent prognosis with no increased risk of epilepsy or neurological damage compared to the general population. No antiepileptic prophylaxis is required. Lumbar puncture is considered in children under 12 months, those with prolonged seizures, or focal features, to rule out meningitis. Parental education on fever management and first aid is the cornerstone of management.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.