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Convulsions (Seizures) Protocol # 12: BY:EMD Adnan Ahmed
Convulsions (Seizures) Protocol # 12: BY:EMD Adnan Ahmed
PROTOCOL # 12
Febrile convulsion
Definition:- Generalized tonic clonic convulsions which
occasionally occur at the onset of FEVER.
Incidence:- 3-5% in all children.
Etiology (causes):-
- Febrile seizures may signify a serious underlying acute
infections.
- In association with high environmental temp.
Clinical picture:-
Criteria for diagnosis of simple febrile convulsions:-
– Patient type:- Age: 6month to 6years. -
Sex: male more than female.
– Family history: Strong positive.
- Neurologically & metabolically free.
Investigation
Laboratory:-
CSF (cerebral spinal fuild) analysis: Indicated if any
doubt exist regarding the possibility of
meningitis.
EEG:- Indicated in atypical febrile seizure persists for more
than 15 minutes or recurrent more than 3 time/day, or
focal seizures.
A child at risk for developing epilepsy:-
– Positive family history of epilepsy
– Initial febrile seizures before the age of 6 months.
– A febrile seizure.
– Delayed developmental milestone.
– Associated Respiratory Problems (cyanosis).
Prognosis:- Risk for developing epilepsy is 1% in
children without risk factors,9% with risk factors.
Treatment:-
– Immediate first aid measures.
– Measures to lower the temperature:-
Cold fomentation(therpy) / Antipyretics.
– Treatment of the cause of fever e.g Antibiotics
– Short acting anticonvulsant:- Diazepam (valium)
0.25mg/kg/dose.
Generalized absence (Effects)
- The commonest age 5-9 years.
- Rare below 2years and never continue after 15 years.
- Short sudden loss of consciousness.
- The child suddenly stops talking and stares for few
seconds.
- Recovery is immediate and child resumes talking.
- Not associated with limb movement.
- Recurrent up to more than 100 times/day.
- May affect school performance.
Myoclonic epilepsy
- Occurs at any age but is more seen in infants and young
children.
- Usually associated with mental retardation.
-The attack which is very frequent, present with sudden
symmetrical mass jerking involving all limbs.
Status epilepticus
Definition:-
Continuous convulsion or repeated convulsions
without return of the level of consciousness more
than 20 min.
Causes:-
-Sudden withdrawal of anticonvulsant.
-Febrile convulsion in poorly controlled epileptic
patient.
-Metabolic or toxic.
• Advice to parents & child:-
– Give full information about the drug therapy
and stress on not to stop the drug without
medical advice.
– Allow normal activities:- the child should be
attended by a responsible adult while bathing
or swimming.
– Give clear instructions about the first-aid
measures in case the seizures:
1. Ensure patent airway.
2. Avoid biting the tongue
3. Putting the child in the prone or side position
with head down.
THANK YOU
REGARDS,
AHMER NADEEM
(EMD)