Question

Regarding simple febrile seizure, which one of the following statements is NOT correct?

• A. It is usually seen in children between 6 months and 6 years of age.
• B. The seizure usually lasts for less than 15 minutes.
• C. Rectal diazepam given at the onset of febrile illness can reduce the incidence of recurrent febrile seizure.
• D. Oral phenobarbitone is usually prescribed after the first episode of seizure to prevent recurrences.

Hint:

Routine long term anticonvulsant prophylaxis is not started after just one simple febrile seizure.

Answer 1

The Correct Option is D

Step 1: Recall the definition of simple febrile seizure.
A simple febrile seizure is a generalized, brief convulsion linked to fever in a young child, without an underlying central nervous system infection or past history of seizures without fever.

Step 2: Analyze the age range.
Simple febrile seizures classically occur in children between 6 months and 6 years of age, with the peak around 18 months. This statement is a correct, standard fact.

Step 3: Analyze the duration.
By definition, a simple febrile seizure lasts less than 15 minutes and does not recur within 24 hours. A seizure lasting longer, or recurring within the same illness, is called a complex febrile seizure instead. This statement is also correct.

Step 4: Analyze rectal diazepam prophylaxis.
Giving rectal diazepam at the start of a febrile illness, and continuing it through the fever, has been shown to lower the chance of a recurrent febrile seizure during that illness. This intermittent prophylaxis is an accepted, correct statement.

Step 5: Analyze oral phenobarbitone.
Continuous daily phenobarbitone can lower the recurrence rate of febrile seizures, but it is not routinely started after just one simple febrile seizure. Current teaching avoids routine long term anticonvulsant prophylaxis after a first simple febrile seizure because the seizure itself is benign and phenobarbitone carries real risks, including behavior and learning side effects in young children, so the small benefit does not outweigh the drug risk. This statement is therefore not correct.

Step 6: Final answer.
The incorrect statement about simple febrile seizure is \[ \boxed{\text{Oral phenobarbitone is usually prescribed after the first episode to prevent recurrences}} \]