Febrile convulsions

Question 1

Definition

Answer 1

Seizure in association with a fever with no definable intracranial cause.
They happen in febrile children between the age of 3 months to 6 years.
By far the most common cause of seizures in children.

Question 2

Definition

Answer 2

Seizure in association with a fever with no definable intracranial cause.
They happen in febrile children between the age of 3 months to 6 years.
By far the most common cause of seizures in children.

Question 3

Risk factors

Answer 3

1. Genetics
2. Age
3. Viral Infections
4. Vaccine or recent immunization
5. High temperature > 38

Question 4

Risk factors

Answer 4

e in association with a fever with no definable intracranial cause

Question 5

Causes of febrile seizure

Answer 5

Upper respiratory infections

Otitis media

Question 6

COMPLEX FEBRILE SEIZURE

Answer 6

1. Focal onset
2. Last longer than 15min
3. Recurrent within 24 hour period
4. Postictal phase common
5. Abnormal neurodevelopment
6. Often no fx of febrile seizures

Question 7

Classification

Answer 7

1. SIMPLE FEBRILE SEIZURE
2. COMPLEX FEBRILE SEIZURE
3. Most febrile seizures are simple

Question 8

SIMPLE FEBRILE SEIZURE

Answer 8

1. Develops within 24 hrs of fever onset
2. Generalized tonic-clonic
3. Last shorter than 15min
4. Normal neurodevelopment
5. Normal neurologic exam
6. Fx of febrile seizures

Question 9

DIAGNOSTIC CRITERIA

Clinical?

Answer 9

1. Exclude intracranial, extracranial and biochemical causes of fever or seizure.
   Signs of meningism are unreliable in children < 2 years of age.
2. If raised intracranial pressure or meningitis cannot be excluded, then the diagnosis of febrile seizures cannot be made. Treat children empirically for meningitis if suspected.

Question 10

Investigations.

Answer 10

Investigations

Lumber Puncture
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Question 11

GENERAL AND SUPPORTIVE MEASURES

Answer 11

Reassure parents and caregivers.

Educate parents and caregivers regarding the first aid management of seizures.

Question 12

MEDICINE TREATMENT

Answer 12

MEDICINE TREATMENT

For fever related symptoms (temperature > 38.5˚C):

Paracetamol, oral, 15 mg/kg/dose 6 hourly.

Paracetamol has no effect on seizure prevention.

NB. If convulsing treat as Status Epilepticus :
Lorazepam, IV, 0.1 mg/kg
OR
Diazepam, rectal 0.5mg/kg/dose

Question 13

REFERRAL

Answer 13

All patients with recurrent complex febrile seizures without an obvious cause of the seizure and/or not responding to initial management should be discussed with a specialist.

Developmental delay/regression