Febrile Seizures Flashcards
What is a seizure?
-it is caused the abnormal excessive discharge of neuronal activity in the brain resulting in occurrence of certain signs and symptoms
What are the signs of a seizure in a infant/ neonate?
- Facial grimacing
- Nystagmus
- Intermittent apnoeic episodes
- Cyclic movements with their hands
- Lip smacking
- Eye blinking
- Myoclonus
- Sudden loss of muscle tone
What are febrile seizures?
-generalised seizures that are associated with a significant fever
What is the criteria for a febrile seizure to be considered?
- Usually children between 6 months and 5 years(specifically 12-18 months)
- Cause of fever outside of the brain (exclude meningitis, encephalitis)
- Family history of febrile seizures
- Temperature of >38,5 degrees
- Normal EEG after 1 week-we often don’t do a EEG though in these patients
- Otherwise well baby-no developmental problems or dysmorphism
How do we classify febrile seizures?
- Simple seizures
2. Complex seizures
What are the characteristics of simple febrile seizures?
- <15 minutes
- No recurrence of seizure within 24 hours
- Generalised tonic clonic (affects the whole body)
What are the characteristics of a complex febrile seizure?
- > 15 minutes
- The seizure re-occurs within 24 hours (usually more than 2 in 24 hours)
- Affects focal areas of the brain
What special investigations do we consider in these patients?
- Try to exclude the cause of fever(exclude meningitis and encephalitis)
- LP- consider in child <12 months because the meningitis may be absent or absent
- Bloods, EEG and CT scan not routinely done
What management do we usually do for these patients?
- Place baby on their side(recovery position)
- Give intermittent diazepam (orally or rectally)
- Sodium valproate or phenobarbitone
When do we consider admitting a baby into hospital?
- Complex febrile seizure
- <1 year old
- Glasgow coma scale <15
- Signs of meningism or increased intracranial pressure
- If baby is unwell
- Parental anxiety
What is the risk of having another febrile seizure?
It is 30%
And non-febrile seizure is common in the first year of life and 75% common in the next 3 years
What increases the recurrence rate to 30%?
- Early age of onset<18 months
- Family history of febrile seizures
- Lower temperature<40 degrees
What is the risk of epilepsy?
-3%
What causes the increase in risk of epilepsy?
- Family history of febrile seizures
- Abnormal neurology prior to first febrile seizure
- Complex febrile seizure
