Febrile convulsions

Question 1

what is a febrile convulsion?

Answer 1

-grand mal seizure
-lasting <5 mins
-secondary to a febrile illness
-not diagnosed with epilepsy already

Question 2

The age group?

Answer 2

btw 6 m -5 y

Question 3

What is the percentage of occurrence?

Answer 3

3%

Question 4

what is the percentage of recurrence?

Answer 4

30%

Question 5

what percentage may develop epilepsy in a long run?

Answer 5

1% out of 3% affected

Question 6

management not fitting in the ED:

Answer 6

-observations
-history
-examine : find out the source of infection or fits
-PCM/ibuprofen if fever
-treat the underlying cause
-discharge to home with safety netting

Question 7

Mgmt: if the child is fitting

Answer 7

-check airways
-O2
-observations : Temp
-IV lorazepam/buccal midazolam/PR diazepam
-PCM if fever
-BM for hypoglycemia
-thorough examination to look for source of fever
-investigations: bloods, MCS, blood cultures, CXR, LP

Question 8

when to discharge the patient?

Answer 8

-if coming with 2nd or subsequent febrile seizure
->2 y
-obvious benign and treatable cause of pyrexia
-liaise with GP to arrange for educating parents regarding midazolam or diazepam

Question 9

when to admit the patient?

Answer 9

-age <2 years
-first fit
-no obvious source of pyrexia
-underlying serious infection