Scribd Logo
Upload

Welcome to Scribd!

  • 38 views

    Seizure Disorders in Children: (Febrile Convulsion)

    Uploaded by

    Alokh Saha Raj
    The document discusses seizure disorders in children, specifically febrile convulsions. It notes that febrile convulsions are a common cause of seizures in young children and occur due to temporary impairment of the brain's balance between convulsant and anticonvulsant systems during fever. The criteria for simple febrile seizures are provided, as well as criteria for complex febrile seizures. Guidelines are given for clinical evaluation, common investigations, treatment including antipyretics and anticonvulsants, prophylaxis for recurrence, and criteria for prophylactic anticonvulsant therapy. The prognosis is typically benign with low risk of long-term issues.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Seizure Disorders in Children: (Febrile Convulsion)

    Uploaded by

    Alokh Saha Raj
    38 views16 pages
    The document discusses seizure disorders in children, specifically febrile convulsions. It notes that febrile convulsions are a common cause of seizures in young children and occur due to temporary impairment of the brain's balance between convulsant and anticonvulsant systems during fever. The criteria for simple febrile seizures are provided, as well as criteria for complex febrile seizures. Guidelines are given for clinical evaluation, common investigations, treatment including antipyretics and anticonvulsants, prophylaxis for recurrence, and criteria for prophylactic anticonvulsant therapy. The prognosis is typically benign with low risk of long-term issues.

    Original Description:

    Convulsion

    Original Title

    FEBRILE-CONVULSION

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document discusses seizure disorders in children, specifically febrile convulsions. It notes that febrile convulsions are a common cause of seizures in young children and occur due to temporary impairment of the brain's balance between convulsant and anticonvulsant systems during fever. The criteria for simple febrile seizures are provided, as well as criteria for complex febrile seizures. Guidelines are given for clinical evaluation, common investigations, treatment including antipyretics and anticonvulsants, prophylaxis for recurrence, and criteria for prophylactic anticonvulsant therapy. The prognosis is typically benign with low risk of long-term issues.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    38 views16 pages

    Seizure Disorders in Children: (Febrile Convulsion)

    Uploaded by

    Alokh Saha Raj
    The document discusses seizure disorders in children, specifically febrile convulsions. It notes that febrile convulsions are a common cause of seizures in young children and occur due to temporary impairment of the brain's balance between convulsant and anticonvulsant systems during fever. The criteria for simple febrile seizures are provided, as well as criteria for complex febrile seizures. Guidelines are given for clinical evaluation, common investigations, treatment including antipyretics and anticonvulsants, prophylaxis for recurrence, and criteria for prophylactic anticonvulsant therapy. The prognosis is typically benign with low risk of long-term issues.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    You are on page 1of 16

    SEIZURE DISORDERS IN

    CHILDREN
    (FEBRILE CONVULSION)
    Causes of Seizure:
    Convulsion with fever Convulsion
    without fever
    • Febrile convulsion • Epilepsy
    • Acute meningitis- • Encephalopathy eg.
    bacterial or viral Hypertensive, hepatic or
    • Cerebral malaria uraemic, hypoxic, ischaemic
    • Viral encephalitis • Trauma eg. Head injury
    • Tubercular • Acute stroke syndrome
    meningitis(TBM) • ICSOL
    • Brain abscess • Metabolic abnormalities
    ( hypoglycaemia, hypo-
    hypernatremia)
    FEBRILE CONVULSION
    • Febrile seizures are a common cause of
    convulsions in young children.

    • Convulsion that occur due to extra cranial


    infection.

    • Occurs due to temporary impairment of the


    balance between the convulsant and
    anticonvulsant system of the brain.
    Criteria of Simple Febrile Seizure
    • Age: Usually 6 mo – 6 years of age
    – Peak occurrence is in children 18 - 24
    months of age
    • Males are affected slightly more.
    • Family history positive.( Autosomal dominant)
    • Convulsion occurs due to rapid rise of
    temperature.
    • Seizure mostly occurs at around >38˚C or
    >101˚F.
    Cont’d…..
    • Seizures are mostly GTCS type.
    • Usually occurs once in 24 hours & within early
    hours of illness.
    • Lasts for few seconds to few minutes; <15
    minutes.
    • No residual neurodefecit except for brief
    period of drowsiness.
    • Absence of signs of meningitis.
    • Recurrence: 50% under 1 year & 30% in other
    situation up to 5 years.
    Complex febrile seizure

    – Lasts 15 minutes or longer


    – Occurs more than once in a 24-hour period
    – Focal or unilateral in nature
    – Patient has known neurologic problems,
    such as cerebral palsy
    – EEG remain abnormal for 2 weeks or more
    following the attack.
    CLINICAL EVALUATION
    A. History:
    • Age
    • Seizure: type, duration, post ictal phase.
    • Fever: nature
    • Family history
    • Developmental status
    B. Physical Examination:
    • ABC
    • Level of consciousness
    • Signs of meningeal irritation
    • Anterior fontanelle
    • Other systems for foci of infection
    Investigations
    1. CSF study:
    • To rule out meningitis,not indicated in all cases.
    • Depends upon the clinical experience &
    judgment of the clinician concerned.
    Indications for CSF study in FS:
    1. Any doubt of meningitis
    2. Age < 1 year
    3. Associated with complex seizure or altered
    sensorium
    4. Slow recovery or prolonged post- ictal phase
    Inv. for Cause of Fever & Convulsion
    1. RBS - ↓
    2. S. Electrolytes -↓ or ↑ Na
    3. S. Calcium - ↓
    4. CBC, PBF, C/S
    5. Urine R/M/E , C/S
    6. CXR
    7. Throat swab C/S
    8. EEG: not recommended in SFS.
    9. Neuro-imaging: No role
    Treatment
    • Explanation & reassurance of parents
    • Removal of excess clothing.
    • Tepid sponging
    • Antipyretic-
    Paracetamol (15mg/kg/dose ) 4-6 hrly
    • Anti-convulsant:
    Inj. Diazepum (0.5 mg/kg/dose P/R or
    0.3mg/kg/dose IV very slowly)
    OR
    Inj. Midazolam (0.2mg/kg) smeared on buccal mucosa
    or intra-nasally
    Prophylaxis for Recurrence
    • Generally prophylaxis (continuous or intermittent) not
    recommended in Simple FS.
    • Intermittent prophylaxis can only be given if parents are
    very anxious till 5 years.
    1. Tepid sponging
    2. Paracetamol 4-6 hry
    3. Tab. Diazepum:(0.5-1mg/kg/day in 3 divided doses for
    48-72 hrs
    OR
    Tab Clobazam: 1 mg/kg/dose single or BD dose for
    48-72 hrs
    AAP Practice Parameter
    • "Based on the risk and benefits of effective
    therapies, neither continuous nor
    intermittent anticonvulsive therapy is
    recommended for children with one or more
    simple febrile seizures. The American
    Academy of Pediatrics recognizes that
    recurrent episodes of febrile seizures can
    create anxiety in some parents and their
    children and as such appropriate educational
    and emotional support should be provided"
    Criteria for Prophylactic Anticonvulsant
    Therapy:

    • Patients under 18 months of age with previous


    abnormal development or abnormal
    neurological signs.
    • Atypical febrile seizure
    • Recurrent febrile seizure
    • High level of parental anxiety
    Prognosis
    • Benign condition leaving behind no
    death or neuro-disability.
    • No adverse effect on academic or
    behavioural activity.
    • Can recur in 1/3rd cases.
    • Chance of epilepsy 2-5%.
    THANK YOU

    You might also like