Febrile convulsions

Question 1

Who gets febrile convulsion?

Answer 1

In toddlers -under 3 y/o typically-can go till 5
3% of children affected

usually with a fever-caused by viral infections

Question 2

Different types of febrile convulsions?

Answer 2

Simple - tonic clonic, generalised
<5mins
spontaneously resolves -recover in 1h
No repeats

Complex- tonic clonic, partial
15-30 mins
can have repeated incidents- cluster

Status epilepticus -over 30misn

Question 3

Signs and Sx of febrile seizures

Answer 3

Brief, generalised seizure in a toddler with a previous fever/current

rhythmical, fast shakes

should not cause brain injury if simple
complex might and can be.a sign of worse illness

Question 4

Ix of Febrile convulsions

Answer 4

Identify and treat cause of fever -
Glucose
potentially - Urine dip, M&S, LP,

other Ix NOT recommended -no EEG/CT/MRI

Question 5

Management of current febrile convulsion

Answer 5

Less than 5mins -dont do anything -protect head and tongue

> 5mins -call ambulance
or if in hospital -
PR diazepam -> buccal midazolam

Question 6

Management after a febrile convulsion

Answer 6

Admission criteria - first convulsion, <18m, uncertain on cause, complex seizures

if not - reassure parents and educate about the condition
Not the same as epilepsy
Reaccurence is 1/3
simples -no risk of epilepsy
Complex -4-12% risk
advise on giving convulsion meds (diazepam)

and teach about Mx a cold-
dont cool kid off, fluid intake, paracetamol/ibu PRN