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Febrile Convulsion - Seizures
Febrile Convulsion - Seizures
CONVULSION /
SEIZURES
By:-
Jwan Ali Ahmed AlSofi
Contents:-
• Case scenario
• Causes of Seizures in the setting of fever
• Definition of Febrile Seizure
• Age of Occurrence
• Types of Febrile Convulsions
• Risks of Recurrent Febrile Seizures
• Risk For Developing Epilepsy After Febrile Seizures
• Workup for Febrile Seizure
• Red Flags in Febrile Seizures
• Treatment
• Prognosis
Case scenario:-
• A 24 months female was brought to the ER after
developing abnormal body movement. She had fever
and cough but no skin rash.
Causes of Seizures in the
setting of fever:-
1. Hemi-Convulsive Seizures.
2. Frequent episodes of Status Epilepticus under one year of age.
3. Febrile Seizure Associated with Meningeal Signs are not
considered Febrile Seizures – must consider an infectious
process.
Treatment
1. ABC
2. Since Simple Febrile Seizures are “benign”, most children require NO treatment
3. Treat Underlying Cause
4. Screen and Treat Iron Deficiency Anaemia.
• Increases risk of Febrile Seizure
5. Control of Fever
• Anti-Pyretics do NOT prevent recurrent Febrile Seizure
• Administration of antipyretics during the same fever episode may reduce the risk of recurrence within that illness, but it
does not seem to impact febrile seizure recurrence during subsequent fever episodes.
6. Rectal diazepam can be administered during a seizure to abort a prolonged convulsion - anti-convulsant if
seizure > 5 minutes
7. Rescue Medications – anticonvulsant prophylaxis during subsequent febrile episodes (Rectal Diazepam
or Buccal/Intranasal Midazolam) – if:-
1. high risk for recurrent febrile seizures
2. history of prolonged febrile seizures
• The American Academy of Pediatrics recommends against prophylaxis with anticonvulsants due an
unacceptable risk–benefit ratio.
8. Long-Term Anti-Convulsant Therapy is controversial (due to its side-effects and the already good prognosis
of Febrile Seizure)
Prognosis
• The prognosis of children with simple febrile seizures is
excellent.
• Intellectual achievements are normal.
Summary
• Febrile Seizures are usually “benign”.
• Most children with Febrile Seizures do not develop
Epilepsy, although it does increase the risk of Epilepsy.
Q. Regarding febrile seizure, all of the following are true except:
A. Onset between 6 months and 6 years.
B. Seizures lasting less than 15 minutes.
C. Positive family history.
D. Seizure is more likely to occur with the rapid rise of temperature.
E. Lumbar puncture is diagnostic.
A 5-years-old male child had history of high fever for 2 days
temp reach to 39.3 C , today mother come to emergency unit
because of abnormal body movement happen twice each one last
3 to 4 minute 12 hours apart, he had a history of attack of febrile
convulsion before 1 year, and in exam his conscious and no
neurological sign the source of infection was follicular tonsillitis.
Q. What type of convulsion did he have?
A. Simple convulsion
B. Complex febrile convulsion