Febrile convulsion

Question 1

How should a parent manage a child during a seizure episode?

Answer 1

• Protect: cushion their head, do not restrain or put anything in their mouth, remove harmful objects nearby
• Airway: once seizure stops, check airway and put them in the
  recovery position
• Time duration of seizure if possible

Question 2

What percentage of children experience febrile convulsion between 6 months and 5 years of age?

Answer 2

4%

Question 3

What are the features of simple febrile seizures?

Answer 3

• • does not last for more than 15 min
  • no focal or asymmetric activity
  • does not recur within 24h
  • not associated with neurological findings

Question 4

What are red flag signs to ask in a history of a seizure in a child? 🛑

Answer 4

• altered level of consciousness
• lethargy
• Brudzinki’s or Kernig’s sign
• non-blanching rash
• focal neurological findings
• is the child below six months or above six years?

Question 5

When does a child require immediate hospital assessment following A&E attendance for a febrile seizure?

Answer 5

• First febrile seizure or if second seizure in a child who has not been assessed before
• < 18 months old
• Uncertain about diagnosis
• Complex febrile seizure
• Focal neurological deficit
• Decreased level of consciousness prior to seizure
• Seizure recurred in the same febrile illness (or within 24 hours)
• Child recently taken antibiotics as can mask signs of CNS infection
• Parents are anxious and/or feel that they cannot cope

Question 6

What advice should be give parents about febrile seizures on discharge?

Answer 6

• They are not the same as epilepsy
• The risk of epilepsy in the future is only slightly higher than the general population
• Short-lasting seizures are not harmful to the child
• 1/3 children will have another febrile convulsion