3. What is seizure?
Is defined as paroxysmal involuntary
disturbance of brain electrical activity.
Manifested as motor, sensory, behavioral,
or autonomic dysfunction
With or without impairment or loss of
consciousness
If seizures manifest as motor act, it is
called convulsions.
Single motor act = fit.
12. Febrile Convulsions
Incidence:
- Affect 4% of children.
- Family history in about 20 % of cases
- Simple febrile seizures is inherited as
autosomal disorder.
- Recurrent in 30-50 % of cases.
14. Febrile Convulsions
Diagnostic criteria:
3- No evidence of CNS
infection (meningitis, abscess) the most
important doctor's responsibility.
4- Evidence of extracranial
infection (viral URTI, tonsillitis, otitis
media, roseola infantum infection)
15. Febrile Convulsions
5- Type of convulsions:
Complex
(complicated)
Typical
(simple)
- Focal seizures.
- Last > 15 min
- Recurring during
the same illness
within 24 hours
- Uncommon.
-Generalized tonic-clonic.
- Last < 15 min.
- One fit only in the same
illness.
- the commonest form.
16. Febrile Convulsions
6- Investigations:
- Usually not needed in children with simple
febrile convulsion.
- Complex form may need:-
- Glucose determination, serum electrolytes.
- Lumbar puncture and CSF analysis.
- Neuro-imaging (CT, MRI).
- EEG.
18. Treatment
1- Fever control .
2- Benzodiazepine: diazepam (I.V. or rectal) if fit
last more than 5 minutes.
3- Treat the underlying cause (antibiotics).
4- Parental advice about fever control.
19. Treatment
Diazepam:
- IV dose: 0.1-0.3 mg/kg (maximum dose is 10
mg/dose) for a maximum of 3 doses.
- Rectal dose: 0.3-0.5 mg/kg diluted in 3 ml NS,
given by syringe and a flexible tube.
- Side effects: Hypotension and respiratory arrest.
20. Treatment
5- Prophylactic anti-convulsants therapy (Na
valproate) may be used for cases carry risk to
develop epilepsy:
- Complex form.
- Pre existing neurologic abnormality
(delayed development milestones).
- Initial febrile seizure developed before 12 m
- Positive family history of epilepsy.
22. Treatment
However, Short- term or long-
term Prophylaxis is no longer
recommended as many drugs
have no effect on febrile
seizures and may decrease
cognitive function.
23. Treatment
6- At the onset of each febrile
illness oral diazepam (1 mg/kg
divided q8 hours )is given for
for 2-3 days to reduce risk of
recurrence in recurrent cases.
24. Differential diagnosis
Seizures associated with fever
1- Meningitis.
2- Viral meningeo-encephalitis.
3- Brain abscess
4- Epileptic fit precipitated by
associated fever.
26. Prognosis:
- Positive family history of febrile
seizures.
2. Epilepsy: Risk is 1% in
absence of risk factors & 9% in
presence of several risk factors.