Case 42 - 11-month-old F with seizures Flashcards
1
Q
Gathering information
A
CC Onset Description of event Duration of seizure Postictal symptoms Tongue or head trauma Whole-body shaking Has this happened before? FHx of seizures Recent illness Fevers, chills Medication for fever Rash Ear tugging N/V/D/C Change in bowel and urinary habits Appetite changes General appearance or demeanor (playful, lethargic, drowsy, irritated) Ill contacts Day care Home environment Health maintenance (last check-up and vaccinations) Birth history Weight, height and language development Eating habits Sleeping habits PMHx PSHx Medications Drug allergies
2
Q
Differential diagnosis
A
Simple febrile seizure (duration < 15 minutes, no prior history, fever of 102.9 F)
Meningitis (tonic-clonic seizure, fever, decreased appetite and urine output)
Hyponatremia causing seizure
3
Q
Diagnostic work-up
A
LP - CSF analysis
CBC with differential
Electrolytes (hyponatremia due to dilute bottle feeds can lead to seizures)
Blood culture, UA and urine culture
4
Q
Simple febrile seizure
A
Most frequent cause of isolated seizure in a child with a common febrile illness
Tend to be familial and may recur, but do not require treatment or cause permanent brain damage
