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BENIGN FEBRILE SEIZURES ( Pediatrics )

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o most common cause of seizure in children
o 3-5% of all children, M > F


Criteria

 

  1. age 6 months - 6 years
  2. thought to be associated with initial rapid rise in temperature
  3. no interictal neurologic abnormalities
  4. no evidence of CNS infection/inflammation or acute systemic metabolic disorder
  5. no history of non-febrile seizures
  6. most common seizure type is generalized tonic-clonic; however may be any type
  7. risk factors include
    • family history of febrile seizures (40% positive)
    • high fever
    • slow development of child

 

Simple Febrile Seizure

 

  1. duration < 15 minutes (95% < 5 minutes)
  2. generalized, symmetric
  3. does not recur in a 24 hour period

 

Atypical Febrile Seizure

 

  1. focal origin
  2. > 15 minute duration, multiple (> 1 in 24 hours)
  3. followed by transient neurologic deficit

 

Risk Factors for Recurrence

 

  1. 33% chance of recurrence
  2. age of onset < 1 year
    • 50% chance of recurrence if < 1 year
    • 28% chance of recurrence if > 1 year
  3. risk of epilepsy is < 5%; risk factors include abnormal development of child previous to seizures, family history of afebrile seizures and a complex initial seizure

 

Workup

 

  1. history: determine focus of fever, description of seizure, meds, trauma history, development, family history
  2. exam: LOC, signs of meningitis, neurologic exam
  3. R/O meningitis – do LP if signs and symptoms of meningitis
  4. EEG not warranted unless atypical febrile seizure or abnormal neurologic findings
  5. investigations unnecessary except for determining focus of fever

Management

 

  1. COUNSELLING AND REASSURANCE TO PATIENT AND PARENTS
  2. antipyretics (e.g. acetaminophen), tepid baths, fluids for comfort (will not prevent seizure)
  3. prophylaxis not given except in very unusual circumstances
  4. if high risk for recurrent or prolonged seizures carry rectal Ativan at home

BENIGN FEBRILE SEIZURES ( Pediatrics ) BENIGN FEBRILE SEIZURES ( Pediatrics ) Reviewed by Radiology Madeeasy on October 02, 2010 Rating: 5
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