Which history detail would most strongly suggest a febrile seizure in a toddler?

• A. The child has had a low-grade fever for several weeks
• B. The family history is negative for convulsions
• C. The seizure resulted in respiratory arrest
• D. The seizure occurred when the child had a respiratory infection

Answer: (D)

Febrile seizures happen in young children during a fever, usually with an acute illness. If a toddler has a seizure at the same time as a respiratory infection, the fever triggered by that infection fits the classic pattern of a febrile seizure. The fever is the provoking factor, not a sign of a deeper neurological problem, and these events are typically brief and generalized.

A fever that’s been present for weeks isn’t the typical trigger for febrile seizures, since they’re linked to acute fever rather than long-standing ones. A negative family history doesn’t change the fact that the seizure occurred with fever, though it might affect recurrence risk. A seizure with respiratory arrest is concerning and suggests a more serious or different pathology, not the common benign febrile seizure.