Febrile convulsions/ seizures Flashcards
(5 cards)
what is a febrile convulsion?
Convulsions in a child aged 6m-6y in the setting of acute febrile illness
WITHOUT:
1) Previous afebrile seizure
2) Significant prior neurological abnormality
3) CNS infection
What are some factors that increase epilepsy?
1) FHx of epilepsy
2) Nuerodevelopmental problem
3) Atypical febrile convulsion (focal or prolonged)
What are the % for epilepsy risk after a febrile convulsion?
1) No risk factors: risk of subsequent epilepsy approx. 1% (similar to population risk).
2) 1 risk factor: 2%.
3) More than 1 risk factor: 10%.
Acute Mx of a convulsion
1) Supportive care for 5 -‐ 10 minutes is appropriate. Ensure adequate airway and breathing while waiting for convulsion to stop spontaneously.
2) If seizure still there–> active management
3) Support airway and breathing, apply oxygen by mask, monitor.
4) Secure IV access
5) Check bedside BSL and send urgent specimen for calcium /electrolytes and VBGS
6) If hypoglycaemia present correct the low sugar.
7) Give benzodiazepine.
8) Repeat after 5 minutes if continuing seizures.
9) If continues for a further 5 -‐ 10 minutes, commence IV phenytoin
Hx for a convulsion
– Timing and how long
– Localising symptoms?
-‐ Travel history
-‐ Sick contacts
– FHx of epilepy
-‐ Immunisation hx
– Any neurodev concerns?
-‐ Ask about growth + development
-‐ Hx of previous episodes
-‐ Significant PHx including seizures, neurological comorbidity, endocrinopathies (electrolyte
disturbance)?
-‐ Focal Sx (loss of muscle control, increased or loss of muscle tone, involuntary movements, paresthesia, loss of coordination, aphasia, decreased visual field, sudden vision loss)
-‐ Evidence of underlying cause that may require additional specific emergency management?
o Hypoglycemia
o Electrolyte disturbance including hypocalcemia
o Meningitis
o Drug overdose
o Trauma (consider occult head trauma)
o Stroke and haemorrhage
