In a pediatric patient with febrile seizures, what is a key management principle?

• A. Start daily antiseizure therapy to prevent recurrence
• B. Most are benign and short; treat fever with antipyretics; long-term antiseizure therapy is not routinely indicated unless complex or recurrent.
• C. Obtain immediate MRI to rule out pathology
• D. Avoid antipyretics to mask fever

Answer: (B)

Febrile seizures in children are usually benign and self-limited, so the management focus is on supportive care and fever control rather than long-term seizure prevention. The best approach is to treat the fever with antipyretics to keep the child comfortable and help reduce fever spikes during febrile illnesses. Long-term antiseizure therapy isn’t routinely indicated because most febrile seizures do not recur in a way that warrants daily medication, unless the seizure pattern is complex—such as a prolonged event, focal features, or multiple seizures within a short period—that would prompt closer evaluation and potentially different management. Routine MRI isn’t needed after a typical febrile seizure unless there are abnormal neurologic findings or red flags that suggest another underlying pathology. Avoiding antipyretics would miss the opportunity to improve comfort during illness, even though they don’t prevent seizures themselves.