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:

Simple febrile seizures are managed with intermittent measures around fever, not routine daily anticonvulsants after just one episode.

Answer 1

The Correct Option is D

Step 1: Understanding the Question:
A simple febrile seizure, a fit brought on by fever in a young child without any brain infection or old neurological problem, has a well defined set of features in pediatrics textbooks. The question wants the one statement here that does not match those accepted features.

Step 2: Key Formula or Approach:
By definition, a simple febrile seizure is a single, generalized (whole body) seizure lasting less than 15 minutes, occurring once in 24 hours, in a child roughly between 6 months and 5 to 6 years of age, with a normal neurological exam otherwise. Prevention strategies focus on intermittent measures around fever episodes, not long term daily drugs, since the small risk of recurrence has to be weighed against side effects in an otherwise healthy child.

Step 3: Detailed Explanation:
Option (a) states the age range as 6 months to 6 years, which matches the accepted age window for simple febrile seizures, so this statement is correct.
Option (b) states the seizure usually lasts less than 15 minutes, which is exactly part of what makes a febrile seizure simple rather than complex, so this is correct too.
Option (c) states that rectal diazepam given at the onset of a febrile illness can reduce recurrence, and this is a real, used strategy: giving diazepam, a benzodiazepine, as soon as fever starts, rather than every day, lowers the chance of a seizure during that particular illness, so this statement is correct.
Option (d) claims oral phenobarbitone is usually prescribed after just the first febrile seizure to prevent recurrence. This is not standard practice: continuous daily anticonvulsant therapy, including phenobarbitone, is not recommended after a single simple febrile seizure, because the seizure itself does not harm the brain, and the drug carries real risks of sedation and behavior side effects that outweigh the modest benefit. Continuous prophylaxis is reserved, if used at all, for select children with frequent recurrences or other risk factors, not routinely after one simple episode.

Step 4: Final Answer:
\[ \boxed{\text{Oral phenobarbitone is usually prescribed after the first episode of seizure to prevent recurrences}} \]