4.2 Seizures

Question 1

Are febrile seizures typically dangerous

Answer 1

no- usually benign and common

Question 2

Febrile seizures are a dx of ___

Answer 2

exclusion

Question 3

What is the NPs role in managing seizures for kids

Answer 3

to consider whether a seizure may have occuredor if a seizure disorder is a likely dx

refer to ped neuro

Question 4

What is the most common type of childhood seizure

Answer 4

febrile seizures

febrile seizure- a seizure that occurs in conjunction with a fever

Question 5

Does the fever occur before or after the seizure

Answer 5

can occur before or after

Question 6

What temp is considered a fever

Answer 6

38C

Question 7

What age to febrile seizures typically occur

Answer 7

6 months - 60 months (5 years old)

60 months = 5 years old

Question 8

If a seizure occurs with a fever outside of 6-60 months what should be done

Answer 8

further workup

Question 9

Febrile seizures can present as simple or complex. How does a simple febrile seizure present

Answer 9

as generalized seizures and last for less than 15 minutes

Question 10

Febrile seizures can present as simple or complex. How does a complex febrile seizure present

Answer 10

generalized or focal seizures, duration greater than 15 minutes, and/or with clustering of seizures (multiple seizures
without recovery between)

Question 11

What is febrile SE

Answer 11

a febrile seizure lasting over 30 minutes which typically requires prompt medical intervention to control

Most children in febrile SE require one or more medications to end the seizure.

Question 12

In which two pediatric populations are febrile seizures more likely to occur

Answer 12

• fam hx of febrile seizures
• predisposing factors (NICU stay, developmental delay, day care attendance)

Question 13

Do kids who have a febrile seizure always have another one

Answer 13

no, 2/3s do not have another one

Question 14

What are risk factor for recurrence of febrile seizures

4

Answer 14

• first febrile seizure prior to 18 months old
• low temp at time of seizure
• fever not present until after seizure
• fam hx febrile seizures

Question 15

When should an EEG be done in febrile seizures

Answer 15

all complex febrile seizures

not typically needed for simple ones

Question 16

When should MRIs be ordred for patients with febrile seizures

2

Answer 16

all complex febrile seizures
focal exam findings

Question 17

What two febrile conditions can be confused with febrile seizures

Answer 17

• febrile delirium
• febrile sivering

Breath-holding spells can mimic febrile seizures; however, breathholding is always related to crying or tantrums.

Question 18

If the child is having a febrile seizure infront of you what are the 3 top priorities

Answer 18

• place on side
• time duration
• longer than 5 mins in duration call 911

Question 19

Does the use of antipyretics prevent further febrile seizures

Answer 19

no not always

Question 20

After a febrile seizure how should the fever be managed

Answer 20

antipyretics- tylenol/advil

Question 21

Is there prophylaxis for recurrent febrile seizures?

Answer 21

no

Prophylactic pharmacologic management is not indicated.

Providers can prescribe a rescue medication (rectal diazepam, intranasal midazolam or buccal
clonazepam) to be used for prolonged febrile seizures or clusters of febrile seizures in the prehospital setting.

Antipyretics can reduce the discomfort associated with a fever but do not alter the risk of having another febrile seizure.

Question 22

Is there anything that can be done to prevent febrile seizures

Answer 22

no

Question 23

Are there long term consequences associated with febrile seizures

Answer 23

no- although complex seizures should be further worked up (EEG, MRI<– referral to peds)

Death or persisting motor deficits do not occur in patients with febrile seizures outside of febrile SE. No indication has been found that intellect or learning is impaired. Children with complex febrile seizures may have a slightly increased risk to develop epilepsy later in life.

Question 24

question on exam on absent seizures- look in text couldnt find any info on that