Clinical Spectrum & Outcome of Febrile Seizures in Children Admitted to A Pediatric Ward

Background: Febrile seizures are the most common convulsive event of childhood, and most episodes are benign. Prolonged and complex seizures may carry a risk of adverse neurological outcomes. Hospital-based data on short-term outcomes from Bangladesh are limited. Objective: To describe the clinical spectrum, management, and short-term outcomes of febrile seizures in children admitted to a pediatric ward and to identify factors associated with neurological deficit at discharge. Methods: This prospective observational study was conducted in the Department of Pediatrics, Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh, from January to June 2026. Fifty children aged 6 months to 11 years admitted with febrile seizure were enrolled by consecutive sampling after written informed consent from parents or guardians. Data on demographics, history, seizure characteristics, cause of fever, laboratory findings, investigations, treatment, and outcomes were collected using a structured proforma. Seizures were classified as simple or complex. Continuous variables were summarized as mean ± SD or median (IQR), and categorical variables as frequencies and percentages. Factors associated with neurological deficit at discharge were tested using Fisher's exact test, with p < 0.05 considered significant. Results: The mean age was 56.5 ± 25.5 months, and 60% were boys. Previous febrile seizures occurred in 64%. Fifty-four percent of seizures were simple and 46% were complex. Seizures were generalized in 88%. Ten percent lasted more than 15 minutes (febrile status epilepticus), and 40% recurred within 24 hours. A viral fever or no focus was the most common cause (72%), followed by urinary tract infection (10%). Lumbar puncture, EEG, and neuroimaging were performed in 16%, 8%, and 20% of children, respectively. During admission, 30% had seizure recurrence and 16% needed HDU/ICU care. The median hospital stay was 5 days. Three children (6%) had a neurological deficit at discharge. Deficit was associated with seizure duration >15 minutes (p < 0.001), febrile status epilepticus (p < 0.001), and HDU/ICU admission (p = 0.003). Conclusion: Most children recovered without sequelae, but those with prolonged seizures were at higher risk of neurological deficit at discharge. These findings are preliminary because of the small sample and few events.