FEBRILE SEIZURES in children summarized

                                FEBRILE SEIZURES  

Dr Saima Khatoon

Febrile seizures are the seizures that occur between 6 to 60 months of age.

INCLUSION CRITERIA

Temperature 100.4*F or higher.

In the absence of history of prior afebrile seizures,

CNS infection

 or metabolic abnormality.

They are of 2 types simple febrile seizures and complex febrile seizure

Simple febrile seizure	Complex febrile seizures
Lasts for 15 minutes	Lasts for more than 15 minutes
Usually generalized	Usually Focal
Does not reoccur in 24 hours	Reoccurs in 24 hours
Less chances of developing epilepsy	More chances of developing epilepsy later on

Risk factors for recurrence of febrile seizures:

Age < 1 year

Duration of fever <24 hours

Fever 100.4 to 102.2*F

Family history of febrile seizures,epilepsy  and complex febrile seizure.

Male gender

Daycare

Risk Factor of developing epilepsy after Febrile seizure:

Simple febrile seizure	1%
Recurrent febrile seizures	4%
Complex febrile seizure( >15min type)	6%
Complex febrile seizures(focal type)	29%
Neurodevelopmental delay	33%
Family history of epilepsy	18%

Etiology:

Viral rather than bacterial infections cause disturbance in cerebral electrical activity.

Respiratory infection is predisposing cause.

Management:

Make left lateral position of the patient, preferably the recovery position.

Clear the Airway.
Give oxygen inhalation as brains oxygen demand increases during seizures .

Check blood sugar level.
Secure iv line , and give inj Diazepam 0.2 mg/kg/dose
If iv line cannot be secured give per rectal diazepan with a needle less 1cc syringe lubricated with lignocaine gel in the same dose.
Buccal or intranasal midazolam may be given in the dose of 0.1mg/kg/dose
do Tepid water sponging and injection Paracetamol 10mg/Kg i/v

Take history, do physical examination to locate the source of infection, and treat the sources of infection accordingly(Antibiotic? Labs?). The source of infection is usually URTI. In an older child(beyond 18months check SOMI).
Counsel parents about risk of recurrence and 1st aid management  at home.