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Index
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Paediatrics: Febrile Seizure
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Chapter 1
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Level 1
level: Level 1
Questions and Answers List
Febrile Seizures
level questions: Level 1
Question
Answer
Fever with fit (3months - 6years) Brain doesnt fully developed yet Genetic predisposition Usually occur with sudden rise of temperature Benign event with good prognosis No neurological deficit Not affecting intelligence
What is febrile seizure? How do we explain febrile seizure to parents?
1. stay calm & dont panic 2. loose cloth esp around neck 3. left lateral position 4. wipe any secretion 5. dont put anything inside the mouth 6. take note the duration 7. during fever, do tepid sponging, encourage fluid intake, good aeration 8. can record video if available
Advice to parents regarding management of febrile seizure at home
1. first time, recurrent? 2. pre ictal - what is pt doing before, aura? crying, irritability? 3. ictal - focal or GTC? uprolling of eyeball, jerking of arm & legs, spasm of peripheries, drooling of saliva, duration 4. post ictal - drowsiness, consciousness? 5. family hx of febrile seizure - 1st degree? 6. Ruling out cause of infection - acute tonsilopharyngitis, otitis media, URTI, UTI
hx of febrile seizure
1. Rule out acute meningitis - irritability, high pitch cry, neck stiffness, projectile vomiting, poor feeding, seizure - focal, >15mins, recurrent 2. Electrolyte imbalance - Na, PO4, Mg, Ca, K (not usually) 3. Hypoglycemia - last meal? known DM? 4. Perinatal infection - intrauterine infection, trauma during pregnancy 5. Febrile fit is diagnosis of exclusion
Patient came with fever and fit. Differential diagnosis?
General: general built, BMI, syndromic features?, normal w & h? sign of neurocutaneous stigmata, hydration status Neuro examination UL, LL - tone, power, reflex cranial nerve, sensory otoscope -if otitis media fundoscope - evidence of papilledima
PE of febrile seizure
1. fbc - wbc 2. rp - check for electrolyte imbalance 3. urine c+s - to rule out UTI 4. blood c+s - identify organism of infection 5. random blood glucose - to rule out hypoglycemia 6. EEG 7. Sign of meningism - LP
Ix of febrile seizure
1. tepid sponging 2. fit chart 3. syrup PCM 15mg/kg 4. i/o chart 5. fit education/diary
mx of febrile seizure