Febrile seizures are non-epileptic seizures triggered by fever between ages 6 months to 5 years. They are generally brief and self-limiting, resolving within 15 minutes. Febrile seizures are classified as simple or complex depending on duration and recurrence. While frightening, febrile seizures typically cause no long term issues and have a low risk of developing epilepsy. Proper management involves antipyretics, observation, and reassurance of parents on typical prognosis.
Febrile seizure / Pediatrics
Simple vs. Complex seizure
Possible explanation of febrile seizure
Risk Factors for Febrile Seizures
Risk Factors for Recurrence of Febrile Seizure
Risk Factors for Occurrence of Subsequent Epilepsy After a Febrile Seizure
Genetic Factors
Evaluation
Lumbar Puncture
Optional LP
Electroencephalogram
Blood Studies
Neuroimaging
TREATMENT
this is a complete discussion and an approach to a child with febrile seizure / convulsion.
It contains:-
Case scenario
Causes of Seizures in the setting of fever
Definition of Febrile Seizure
Age of Occurrence
Types of Febrile Convulsions
Risks of Recurrent Febrile Seizures
Risk For Developing Epilepsy After Febrile Seizures
Workup for Febrile Seizure
Red Flags in Febrile Seizures
Treatment
Prognosis
Febrile seizure / Pediatrics
Simple vs. Complex seizure
Possible explanation of febrile seizure
Risk Factors for Febrile Seizures
Risk Factors for Recurrence of Febrile Seizure
Risk Factors for Occurrence of Subsequent Epilepsy After a Febrile Seizure
Genetic Factors
Evaluation
Lumbar Puncture
Optional LP
Electroencephalogram
Blood Studies
Neuroimaging
TREATMENT
this is a complete discussion and an approach to a child with febrile seizure / convulsion.
It contains:-
Case scenario
Causes of Seizures in the setting of fever
Definition of Febrile Seizure
Age of Occurrence
Types of Febrile Convulsions
Risks of Recurrent Febrile Seizures
Risk For Developing Epilepsy After Febrile Seizures
Workup for Febrile Seizure
Red Flags in Febrile Seizures
Treatment
Prognosis
ACUTE FLACCID PARALYSIS
Kanishk Deep Sharma
definition
Sudden onset of weakness or paralysis over a period of 15 days in a patient aged less than 15 years age
Ddx
poliomyelitis
Non enveloped, positive stranded RNA virus
Genus ENTEROVIRUS
family PICORNAVIRIDAE
3 antigenically distinct serotypes:-1,2,3
pathogenesis
•Entry into mouth.
•Replication in pharynx, GI tract, Local Lymphatic.
•Hematologic spread to lymphatic and central nervous system.
•Viral spread along nerve fibers.
•Destruction of motor neurons
Immunity
Initially protected by maternal antibodies for first few weeks of life
Types
Asymptomatic
Abortive Polio
Non-paralytic
Paralytic
Spinal
Bulbar
Bulbospinal
Cf- asymptomatic
• Accounts for approximately 95% of cases
• Virus stays in intestinal tract and does not attack the nerves
• Virus is shed in the stool so infected individual is still able to infect others
Cf-abortive
•Does not lead to paralysis
•Mild symptoms seen such as sore throat, fever, n/v, diarrhea, constipation ( Minor illness)
•Most recover in <1><5><4days />95% immune after 3 doses
Immunity probably lifelong
Inactivated polio vaccine
Humoral immunity and to some extend pharyngeal immunity
Duration of immunity not known with certainty
Strategies for polio eradication
Global Polio Eradication Initiative launched in 1988
Polio cases have decreased by over 99%
1988 - >125 countries
In 2010 - 4 countries
The remaining countries are Afghanistan, India, Nigeria and Pakistan
Core strategies
High infant immunization coverage with four doses of oral poliovirus vaccine (OPV) in the first year of life
Supplementary doses of OPV to all children under five years of age during national immunization days
AFP surveillance among children under fifteen years of age
Targeted “mop-up” campaigns once wild poliovirus transmission is limited to a specific focal area.
Immunisation in india
Polio Vaccination under UIP
OPVº birth
OPV1 6 wks
OPV2 10 wks
OPV3 14 wks
OPV4 16-24 Months
Pulse Polio Immunization (PPI)
The supplementary immunization activities (SIAs) in India launched in 1995
Irrespective of the immunisation status
Usually Dec & Jan – Peak transmission
aim
Providing additional OPV doses to every child aged <5><15 years who have had the onset of flaccid paralysis within the preceding 60 days
All cases that are found are investigated immediately, with collection of two stool specimens before administration of OPV.
Slideshows on febrile seizures.. Simple and basic details available. For medical students, housemen and training doctors who wish to revise on the topic.
Fever is common problem for children,
If care will be not taken they may get
Fits due to high fever.
They are called fits, Convulsions or seizures due to fever in children.
We will see
The Cause, treatment, diagnosis etc
ACUTE FLACCID PARALYSIS
Kanishk Deep Sharma
definition
Sudden onset of weakness or paralysis over a period of 15 days in a patient aged less than 15 years age
Ddx
poliomyelitis
Non enveloped, positive stranded RNA virus
Genus ENTEROVIRUS
family PICORNAVIRIDAE
3 antigenically distinct serotypes:-1,2,3
pathogenesis
•Entry into mouth.
•Replication in pharynx, GI tract, Local Lymphatic.
•Hematologic spread to lymphatic and central nervous system.
•Viral spread along nerve fibers.
•Destruction of motor neurons
Immunity
Initially protected by maternal antibodies for first few weeks of life
Types
Asymptomatic
Abortive Polio
Non-paralytic
Paralytic
Spinal
Bulbar
Bulbospinal
Cf- asymptomatic
• Accounts for approximately 95% of cases
• Virus stays in intestinal tract and does not attack the nerves
• Virus is shed in the stool so infected individual is still able to infect others
Cf-abortive
•Does not lead to paralysis
•Mild symptoms seen such as sore throat, fever, n/v, diarrhea, constipation ( Minor illness)
•Most recover in <1><5><4days />95% immune after 3 doses
Immunity probably lifelong
Inactivated polio vaccine
Humoral immunity and to some extend pharyngeal immunity
Duration of immunity not known with certainty
Strategies for polio eradication
Global Polio Eradication Initiative launched in 1988
Polio cases have decreased by over 99%
1988 - >125 countries
In 2010 - 4 countries
The remaining countries are Afghanistan, India, Nigeria and Pakistan
Core strategies
High infant immunization coverage with four doses of oral poliovirus vaccine (OPV) in the first year of life
Supplementary doses of OPV to all children under five years of age during national immunization days
AFP surveillance among children under fifteen years of age
Targeted “mop-up” campaigns once wild poliovirus transmission is limited to a specific focal area.
Immunisation in india
Polio Vaccination under UIP
OPVº birth
OPV1 6 wks
OPV2 10 wks
OPV3 14 wks
OPV4 16-24 Months
Pulse Polio Immunization (PPI)
The supplementary immunization activities (SIAs) in India launched in 1995
Irrespective of the immunisation status
Usually Dec & Jan – Peak transmission
aim
Providing additional OPV doses to every child aged <5><15 years who have had the onset of flaccid paralysis within the preceding 60 days
All cases that are found are investigated immediately, with collection of two stool specimens before administration of OPV.
Slideshows on febrile seizures.. Simple and basic details available. For medical students, housemen and training doctors who wish to revise on the topic.
Fever is common problem for children,
If care will be not taken they may get
Fits due to high fever.
They are called fits, Convulsions or seizures due to fever in children.
We will see
The Cause, treatment, diagnosis etc
Headache in children -indexforpaediatrics.comdr-nagi
Headache is one of the commonest neurological symptoms in children and young people who are
referred to doctors. Headache refers to pain involving the orbits, forehead, scalp and temples but not
the face or neck. The primary headache includes chronic or recurrent headache and migraine. The
prevalence of chronic or recurrent headaches in children occur in 60-69% by the age of 7-9 years
and 75% by the age of 15 years. The prevalence of migraine in children is up to 28% of older
teenagers. The most serious cause of the secondary headache is brain tumor and the prevalence of
brain tumours in children is 3 per 100,000 per annum.
https://indexforpaediatrics.com
Seizure disorder is one of the important topic in children and adult also. here i explained the seizure disorder in pediatrics, include all most content for nurses level
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
2. Outline for today’s discussion
• Introduction to seizures
• Definition and classification of febrile seizures
• Etiology and epidemiology
• Clinical features and differential diagnosis
• Risk factors for recurrence and epilepsy
• Diagnosis and management
3. Seizure/ Convulsion
Definition: A seizure is a transient recurrence of signs and/ or
symptoms resulting from abnormal excessive or synchronous neuronal
activity in the brain.
• Seizures are of two types;
1. Epileptic
2. Non-epileptic
4. Epileptic Seizures
• Have no apparent trigger (they are unprovoked) and they occur two or
more times.
• One seizure is not considered epilepsy.
• Epileptic seizures are referred to as a ‘Seizure disorder’ or Epilepsy.
• They have no known cause, but may be caused by various brain
disorders such as strokes and tumors.
• This is called symptomatic epilepsy, and is most common among new-
borns and older people.
NB: Epilepsy is defined as recurrent seizures unrelated to fever or to an
acute cerebral insult in a time frame of more than 24 hours.
5. Non-epileptic Seizures
• These seizures are triggered (provoked) by a reversible disorder or a
temporary condition that irritates the brain.
• Some of these conditions include infection, head injury or reaction to
a drug.
• In children, a fever can trigger a non-epileptic seizure, known as a
febrile seizure.
6. Febrile Convulsions or Seizures
• Febrile seizures are seizures that occur between the age of 6 and 60
months with a temperature of 38°C or higher, that are not the result
of central nervous system infection or any metabolic imbalance, and
that occur in the absence of a history of prior afebrile convulsions.
Or
• Febrile seizure is a generalized tonic-clonic seizure associated with a
rapid rise in temperature due to an extracranial illness. (Uganda
Clinical Guidelines)
7. Criteria for Febrile convulsions
• Age of 6 months to 60 months
• Most febrile seizures occur between the ages of 12-24 months
• Fever of 38°C or more
• Non central nervous system infection or metabolic imbalances
8. Exclusion to diagnosis
• A history of previous afebrile convulsions
• CNS infection or inflammation
• Cerebral malaria
• Acute systemic metabolic abnormality causing convulsions e.g.
cerebral folate deficiency
9. Classification of Febrile Seizures
They are classified into three types:
I. Simple febrile seizure
II. Complex febrile seizure
10. Cont.
I. Simple febrile seizure: This is a primary generalised, usually tonic-
clonic, attack associated with fever, lasting for a maximum of 15
minutes, and not recurrent within a 24 hour period.
II. Complex febrile seizure: This is more prolonged (>15 minutes),
focal and/or recurs within 24 hours.
• Febrile status epilepticus is a complex febrile seizure lasting > than 30
minutes
11. Etiology
• The exact mechanism is unknown
• Although, a rapid increase in body temperature has been postulated
to be the cause.
• Viral, rather than bacterial infections cause disturbance of electrical
activity. The common infections include malaria, UTIs, otitis media,
roseola and human herpesvirus 6 (HHV6). May also be due to shigella.
• It has also been associated with genetic factors
12. Genetic factors
• This is manifested by a positive family history of febrile seizures
• The disorder is inherited as an autosomal dominant trait in some
families
• Many singles genes have been identified e.g. FEB 1,2,3,4,5,6 and 7
genes. Only the function of FEB 2 is known: it is a sodium channel
gene
• In most cases, the disorder is polygenic and the genes responsible are
unknown
13. Epidemiology
• They are the most common cause of childhood convulsive disorder
• Occurs in about 2-5% of neurologically healthy infants and children.
They experience at least one, usually simple febrile seizure.
• They are twice as common in boys than girls
• Simple febrile seizures have no increased risk of mortality
• Complex febrile seizures may have a 2 fold increase in mortality
compared to general population over subsequent 2 years
14. Clinical features
• Elevated temperature (> 38°C )
• Convulsions, usually brief and self-limiting
• No neurological abnormality in the period between convulsions
• Generally benign and with good prognosis
16. Points to note
• More than 90% of seizures are generalised, are less than 5 minutes
duration, and occur early in an illness (e.g. otitis media, roseola,
pharyngitis)
• A strong family history of febrile convulsions in siblings and parents
suggests a genetic predisposition
• Complex febrile seizures have a higher risk of epilepsy or recurrent
non-febrile seizures.
17. Risk factors for recurrence of F. Seizures
Major
• Age less than 1 year
• Duration of fever less than 24 hours
• Low grade fever less than 38°C
Minor
• Family history of febrile seizures
• Family history of epilepsy
• Complex febrile seizure
• Day care
• Male gender
• Lower serum sodium
18. Risk factors for subsequent Epilepsy
• Simple febrile seizure (1%)
• Neurodevelopmental abnormalities (33%)
• Focal complex febrile seizures (29%)
• Family history of epilepsy (18%)
• Fever <1 hour before febrile convulsion(11%)
• Complex febrile seizure, of any type (6%)
• Recurrent febrile seizures (4%)
19. Clinical Work-up
I. Take a detailed history
• How long the seizure lasted, what happened during the seizure (body
stiffening, twitching of the face, arms and legs, staring, loss of
consciousness), did the child recover within 1 hour, have they had a
seizure before?
II. Do thorough general and neurological exam
III. Do investigations
20. Investigations
1. CBC
2. Blood: Slide for malaria parasites
3. Lumbar puncture if required (in children <12 months is an absolute
indication to rule out meningitis due to subtle clinical symptoms)
4. Blood glucose and electrolytes
5. Urinalysis, culture and sensitivity
6. An electroencephalogram is indicated only when epilepsy is highly
suspected. EEG should be done at least 2 weeks after illness to prevent
transient findings in EEG due to fever or seizure itself.
7. Neuroimaging, to check for neurological abnormalities
21. Meningitis must be ruled out
Lumbar puncture must be performed in children:
• With any suspicion of meningitis
• Under 1 year of age is an absolute indication
• When recovery from a febrile convulsion is slow
NB: Lumbar puncture in children 12-18 months is a relative indication
and is performed only if meningitis is suspected.
• DO NOT do a lumbar puncture in children older than 18 months
unless they show signs of meningitis. E.g. positive Kernig’s or
Brudzinski's sign.
22. Management
• Use tepid sponging to help lower the temperature
• Give an anti-pyretic: paracetamol 15mg/kg every 6 hours until fever
subsides.
• Diazepam has no role in the treatment of febrile seizures.
• Place nothing in the child’s mouth
• Maintain ABCs if child is unconscious
• Place the child on their side (recovery position) to prevent aspiration.
• Observe the child in the emergency room for 6-12 hours and then
revaluate.
• Admit the child if the clinical situation is not stable after observation e.g.
when an underlying condition like meningitis is present.
23. Cont.
• After observing the child, discharge if clinical condition is stable.
• On discharge, counsel & reassure parents using the parameter below
The seizure is frightening but it does not cause brain damage
The possibility of the child developing epilepsy is very low
There is a possibility that the seizure may recur in the next 24 hours
If the seizure recurs, place the child on their side and observe for
recovery
If the seizure takes longer than 5 minutes, parent should return with
child to hospital
Long term therapy with anticonvulsants is not recommended