Careful general exam, neuro exam - identify source of fever. If child looks normal and F.S. was simple, an LP is probably not necessary. Decreases the risk of recurrent febrile seizures. Does not reduce the risk of epilepsy. Only for more than 2-3 seizures, early age child.
Phenytoin is ineffective for febrile seizures.
For motivated parents, prophylaxis at the time of a febrile illness is an effective alternative. Use Lorazepam 1 - 2 mg PO or PR q 8 hours until the child is without fever for 24 hours or for 3 days, whichever is less. All rights reserved.