# Febrile Seizures > Febrile seizures for NEET-PG Paediatrics: simple versus complex types, acute management, recurrence risk and investigation rules in exam notes. - Canonical URL: https://prepelephant.com/topics/neet-pg/paediatrics/febrile-seizures - Exam / course: NEET-PG · Subject: Paediatrics - Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team - First published: 2026-10-02 - Last updated: 2026-10-02 - How to cite: "Febrile Seizures", PrepElephant, https://prepelephant.com/topics/neet-pg/paediatrics/febrile-seizures ## Direct answer A febrile seizure occurs with fever of at least 38 degrees Celsius in a neurologically healthy child between six months and five years (peak 12-18 months), in whom CNS infection, metabolic derangement and prior afebrile seizures have been excluded. Simple seizures — the great majority — are generalised, last under 15 minutes, do not recur within the illness and leave no focal deficit; complex seizures have focal features, last beyond 15 minutes or recur within 24 hours. Acute care is positioning and timing, with a benzodiazepine only beyond about five minutes. ## What you must remember - **Definition:** fever of 38 degrees Celsius or more, age six months to five years, no CNS infection, no metabolic cause and no previous afebrile seizure — all conditions must hold. - **Simple versus complex:** simple — generalised, under 15 minutes, one per illness, no focal features; complex — any focal feature, longer than 15 minutes, or recurrence within 24 hours, with higher later epilepsy risk. - **Acute management:** turn the child to the side, protect from injury and time the seizure; past about five minutes, give buccal or intranasal midazolam or rectal diazepam, then hospital assessment. - **Investigation rules:** a child who recovers fully after a simple seizure needs no EEG, neuroimaging or lumbar puncture — testing targets the fever source instead. - **Lumbar puncture considerations:** for meningeal signs, or an incompletely immunised or pretreated infant under about a year — not routinely after a simple seizure in a well child. - **Recurrence:** roughly a third of children have another febrile seizure, risk raised by young age at onset, family history and low fever degree. - **Prognosis:** most never develop epilepsy, the risk rising mainly with complex features or family epilepsy; antipyretics do not prevent recurrence, and continuous antiepileptics are rarely justified. ## Common confusion The classic trap is missing meningitis: a seizing febrile child under one year who is irritable, has a bulging fontanelle or is incompletely immunised needs lumbar puncture, whereas the playful toddler after a brief generalised seizure does not. The second confusion is parental expectation of fever control — paracetamol and sponging comfort but have never prevented febrile seizures. A first seizure in an older child, or any focal onset, shifts the differential toward epilepsy instead. ## Exam-focused takeaway NEET-PG tests definitional precision and restraint: the age window, the four exclusions and the simple-versus-complex columns (15 minutes, focality, recurrence in 24 hours). Management stems ask the first step (side positioning and timing), the drug beyond five minutes (buccal midazolam or rectal diazepam) and — most often — which test is not needed (EEG, CT or routine LP after a simple seizure). Prognosis one-liners cover the one-in-three recurrence figure and the epilepsy risk with complex features. ## Frequently asked questions ### What defines a febrile seizure? A seizure with fever of 38 degrees Celsius or more in a child of six months to five years, with no CNS infection, no metabolic cause and no prior afebrile seizures. ### How do simple and complex types differ? Simple seizures are generalised, under 15 minutes, solitary per illness and non-focal; complex seizures are focal, prolonged beyond 15 minutes or recurrent within 24 hours. ### What is the immediate management? Place the child on the side, protect from injury and time it; past five minutes, give buccal or intranasal midazolam or rectal diazepam. ### Which children need a lumbar puncture? Those with meningeal signs, or incompletely immunised or pretreated infants under a year — not the well child after a simple seizure. ### What is the chance of recurrence and epilepsy? About one in three recur, highest with young onset and family history; epilepsy stays uncommon, rising chiefly with complex seizures.