Febrile Convulsion Flashcards
Define febrile convulsion.
Seizure associated with fever occurring in a child between 6 months and 5 years. Febrile seizures usually arise from infection/inflammation outside the CNS in an otherwise neurologically normal child. Seizures arising from fever due to meningitis or encephalitis are not included in the definition of febrile convulsion.
What is a simple febrile convulsion?
Isolated, brief, generalised clonic/tonic-clonic seizure.
What is a complex febrile convulsion?
>15 minutes, focal features, repeat seizure within the same illness or incomplete recovery from seizure <1 hour.
What is febrile status epilepticus?
Duration >30 min (up to 5% present as status epilepticus).
Explain the aetiology/risk factors for febrile convulsion.
Genetic: 50% concordance rate in monozygotic twins, FH of febrile seizures.
An infection outside the nervous system.
Summarise the epidemiology of febrile convulsion.
4% in Western Europe and USA. Peak age in 18 months.
What are the symptoms of febrile convulsion?
History of viral URTI, otitis media, pneumonia, UTI or gastroenteritis.
May occur after immunization.
Fever, fits.
What are the signs of febrile convulsion?
Fever (above 38.3), respiratory distress, tachycardia, tachypnoea, ENT examination.
No signs of meningitis and encephalitis (behavior, drowsiness or irritability).
What are some investigations for febrile convulsion?
Clinical diagnosis. Other tests are only indicated if there is suspicion of sepsis, menigitis or encephalitis.
Bloods: FBC, Sodium (U&Es), Glucose, blood culture and viral studies.
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Brain MRI and EEG.
What is the management for febrile convulsions?
Admission to hospital for observation.
Rectal diazepam or buccal midazolam if the seizure prolongs.
Ibuprofen or paracetamol.
What are complications associated with febrile convulsions?
Mesial-temporal sclerosis with prolonged febrile status epilepticus.
What is the prognosis for febrile convulsions?
Recurrence, small increase in epilepsy.
