What are the indications for referral to a specialist for a child with recurrent febrile seizures?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 17 August 2025Updated: 17 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Referral to a specialist for a child experiencing recurrent febrile seizures is indicated if:

  • The child has neurodevelopmental delay and/or signs of a neurocutaneous syndrome or metabolic disorder, which warrants further assessment by a paediatrician or paediatric neurologist .
  • The child has complex febrile seizures, such as focal seizures, seizures lasting longer than 15 minutes, or multiple seizures within 24 hours, which may require specialist evaluation .
  • There is diagnostic uncertainty about the cause of the seizures or if the child has unexplained fever and no apparent focus of infection .
  • The child has features of a complex febrile seizure, such as focal neurological deficits or decreased level of consciousness prior to the seizure .
  • There is parental/carer anxiety and/or difficulty coping, which may necessitate specialist support and reassurance .

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