Neurology - Febrile Convulsions

Question 1

What are febrile convulsions?

Answer 1

Seizure that occurs in children with a high fever

Question 2

By definition what age are kids affected by febrile convulsions?

Answer 2

6 months - 5 years

Question 3

What are simple febrile convulsions?

Answer 3

Generalised, tonic clonic seizures

Last less than 15 minutes and only occur once in a single febrile illness

Question 4

What are complex febrile convulsions?

Answer 4

Partial or focal seizures

Last more than 15 minutes or occur multiple times during the same febrile illness

Question 5

How are febrile convulsions diagnosed?

Answer 5

Exclude other neurological pathology

Question 6

What are the differentials for a febrile convulsion?

Answer 6

Epilepsy
Meningitis, encephalitis or neurological infection
SOLs
Syncopal episode
Electrolyte abnormalities
Trauma

Question 7

What is the typical presentation for febrile convulsions?

Answer 7

18 month presenting with 2-5 minute tonic clonic seizure during high fever

Fever usually caused by underlying viral illness or bacterial infection e.g. tonsillitis

Once diagnosis made look for infection source

Question 8

How are febrile convulsions managed?

Answer 8

Identify and manage underlying source of infection and control fever with simple analgesia

Investigate complex febriles not simple

Question 9

What advice should be given to parents on managing a seizure if it happens again?

Answer 9

• Stay with child
• Put child in safe space, e.g. carpeted floor
• Recovery position
• Nothing in mouth
• Ambulance if over 5 minutes

Always hospital assessment for first seizure

Question 10

What is the prognosis for febrile convulsions?

Answer 10

No lasting damage

1/3 will have another convulsion

Epilepsy risk is
1.8% for general poplation
2-7.5% after simple febrile convulsion
10-20% after complex febrile convulsion