FEBRILE CONVULSION k41 Flashcards
TASK
Benjamin, a 14-month-old boy, has been brought in to the hospital Emergency Department by his
parent following an episode at home the previous evening. His parent explains that he had been
unwell all day with a high fever (40 °C), and while he was being cuddled, he was staring and did
not respond to his name. They noted that his body twitched all over for several seconds and the
whole episode lasted 60 seconds. He then went off to sleep and slept for the rest of the night.
Examination findings
Benjamin is alert and normal neurologically. He has a low grade fever and signs of an upper j
respiratory tract infection.
YOUR TASKS ARE TO:
* Take any further history to ascertain the most likely cause for this episode.
* Explain your diagnosis and subsequent management to the child’s parent.
HX
-HOPC : Ask more about convulsion(duration<15min,
focal signs),
recover < 1hr
recur with same febrile illnessis he active, oral intake
-complex febrile seizure if above negative
-birth hx : mode, weight, apgar, nicu
RISK FOR DEVELOP EPILEPSY
-development milestones: head, sitting, walking,
-family hx : epilepsy, sister had febrile convulsion
-Prolonged febrile sezure, febrile status epiliepticus
explanation
-most likely febrile convulsion
-common reaction to fever/3% pop
-it is a completely benign
-runs in families
-fever most likely caused by virus>which would manifest as urti adults>but immature brains susceptible to high fever
-convulsion do not cause brain damage or lead to epilepsy
-30 percent chance of recurrence>ct antipyretics for fever
D/D
-unlikely to be epilepsy, only 3percent chance that also(family hx, duration >15min, focal, development norml)
-may use rectal diezepam
factors that make febrile seizure unlikely
<6 months of age (consider CNS infection)
>6 years of age
any features of a complex febrile seizure
signs of CNS infection
previous afebrile seizures
progressive neurological conditions
developmental delay or regression
