Febrile Seizures Flashcards
How common are febrile seizures?
Affect 3-5% of all children
What is a simple febrile seizure?
Aged 6 months - 5 years, febrile >38.5, brief (< few mins), generalised, 1 seizure per illness, rapid recovery with short post-ictal phase (<30 mins), no focal neurology, no signs of CNS infection
How often do febrile seizures reoccur?
25-30% have more than 1 febrile seizure.
If the first febrile seizure is at <12 months old, there is a 50% recurrence rate.
What is the risk of epilepsy after a febrile seizure?
1% risk of subsequent afebrile seizures. This is the same as the general population.
What increases the risk of epilepsy after a febrile seizure?
Increased risk with: complex febrile seizures, developmental delay, family hx of epilepsy/neurological abnormalities
Febrile status epilepticus, focal febrile seizures.
What increases the risk of repeat seizures after a febrile seizure?
Prolonged seizure (> 10 mins), focal, multiple, altered conscious state afterwards, child <12 months, brief duration between fever onset and seizure, family hx of febrile seizures
What is an afebrile febrile seizure?
Seizures in acute infectious illness (particularly gastroenteritis) without documented fever. Other features are consistent with a simple febrile seizures.
Define complex febrile seizure.
Fever and any of the following:
- focal features at onset or during seizure
- duration >10 mins
- incomplete recovery within 1 hour
- recurrence within the same febrile illness
Increased risk of febrile convulsion recurrence if:
FROM DUNN:
Onset < 1 year, FHx febrile seizure, short onset between fever and seizure, seizure at lower temperature
Drug doses for status/febrile status:
Midaz IO/IV 0.1 mg/kg, IN/buccal 0.3 mg/kg
Diaz PR 0.5 mg/kg
Phenytoin/phenobarb 20 mg/kg
Keppra 40 mg/kg
