Paeds: Febrile Convulsions Flashcards Preview

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Flashcards in Paeds: Febrile Convulsions Deck (15):
1

Definition

A febrile seizure is a seizure accompanied by a fever in the absence of intracranial infection due to bacterial meningitis or viral encephalitis.

2

Epi

Occur in 3% of children between the ages of 6 months and 5 years

3

Genetic

10% risk if the child has a first-degree relative with febrile seizures
19q and 19q 13-21 (don’t need to know)

4

Process

The seizure usually occurs early in a viral infection when the temperature is rising rapidly
>39oC

5

Seizure type

Usually brief and are generalised tonic-clonic seizures

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Future episodes

30-40% will have further febrile seizures
• More likely if the child is younger
• Short the duration of illness before the seizures
• The lower the temperature at the time of seizure
• Positive family history.
complex

7

Prognosis

Simple febrile seizures do not cause brain damage; the child’s subsequent intellectual performance is the same as in children who do not experience a febrile seizure.
There is a 1-2% chance of developing epilepsy, similar to the risk for all Children.

8

Types

Simple versus complex

9

Simple

Both are
Secs-15 mins
Only 1/24hrs
Post ictal drowsiness (nothing else)

10

Complex

>15 min
More than 1 in 24hours
Post ictal seizures or movements

11

Management

Find out the cause Rule/out meningitis/encephalitis

12

Epilepsy

Slight increase risk however comes with a range of things like
- Other picture going on e.g. delayed dev milestones
- Fx of epilepsy
-

13

Investigations

- Should focus on the cause of the fever, which is usually a viral illness, but a bacterial infection including meningitis should always should always be considered.
- Infection screen may be necessary
o Blood cultures
o Metabolic: Glucose
o Electrolyte disturbance (Ca and MG)
o Toxicology cause?
o Urine culture
o Lumbar puncture for CSF

14

LP

15

Management:

1. Parental reassurance and information
a. 5 mins buccal midazolam
2. Antipyretics have not been shown to prevent febrile seizures and tepid sponging is no longer recommended
3. Family should be taught the first aid management of seizures
4. If a history of prolonged seizures (>5min), rescue therapy such as rectal diazepam or buccal midazolam can be supplied.
5. Oral prophylactic anti-epileptic drugs are not used as they do not reduce the recurrence rate of seizures or the risk of epilepsy
a. Minimal effect and adverse affects

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