Febrile_Convulsion_Flashcards (1)
What is a febrile convulsion?
A seizure and fever in the absence of intracranial infection.
What is the typical age range for febrile convulsions?
6 months to 3 years (shouldn’t occur in older children).
What is the genetic predisposition for febrile convulsions?
30% will have further seizures.
What are the signs and symptoms of a febrile convulsion?
Brief, generalised tonic-clonic seizure on background of fever.
What characterizes a simple febrile seizure?
Simple febrile seizures do not cause brain damage and do not increase the risk of epilepsy.
What characterizes a complex febrile seizure?
Complex febrile seizures are focal, last >15 minutes, repeated in the same illness, and increase the risk of subsequent epilepsy by 4-12%.
What investigations should be done after a febrile seizure?
Identify and manage the cause of fever. Screen for meningitis/encephalitis, urine MC&S if infection source is unclear, blood glucose.
What is the initial management during a febrile seizure?
Protect from injury (cushion their head, remove nearby objects) and do not restrain.
What should be done if a seizure lasts less than 5 minutes?
Do nothing unless it is the first seizure, severe cause, or there are breathing problems.
What should be done if a seizure lasts more than 5 minutes and no drugs are available?
Call an ambulance if no medication is available.
What should be done if a seizure lasts more than 5 minutes and drugs are available?
Administer one of the following: PR diazepam (repeated once after 5 minutes if the seizure hasn’t stopped) or Buccal midazolam.
What should be done 10 minutes after the first dose if the seizure is ongoing?
Call an ambulance if the seizure, twitching, or another seizure is ongoing.
When should an ambulance be called during a febrile seizure?
Call an ambulance if it is the first seizure, if a seizure is suspected to be caused by a serious illness, if the seizure lasts >5 minutes without drugs, or if there are breathing difficulties.
What is the management after a febrile seizure?
Immediately check ABCs and place the child in the recovery position. Manage all other children at home with advice.
When should a child be admitted after a febrile seizure?
Admission if it is the first febrile seizure, if the child is <18 months old, if there is diagnostic uncertainty about the cause, if it is a complex febrile seizure, or if the child is currently on antibiotics.
