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By Will Stahl-Timmins
More than
Is this a No CNS infection Generalised Focal
30 mins
No previous neonatal
febrile or unprovoked seizures No recurrence May have
seizure? within 24 hours repetitive seizures
Doesn’t meet criteria for other
acute symptomatic seizures No postictal Todd’s paresis
—International League Against Epilepsy pathology may be present
Beware an altern- Red flags suggestive of CNS infection: Any physical signs of
ative diagnosis, Antibiotic treatment Complex febrile seizures meningitis/encephalitis
especially if the • Bulging fontanelle
2 fever is less
than 38°C, or in
History of irritability, decreased feeding or lethargy
Incomplete Postictal symptoms
• Focal neurological signs
• Neck stiffness
infants younger immunisation: lasting more than 1 hour
Consider than 6 months.
• Photophobia
• Haemophilus • Limited social response
alternative Causes could influenzae B • Altered consciousness !
Symptoms and signs of
meningeal irritation may
diagnoses include CNS infec- • Streptococcus • Neurological deficit be absent in children
tions or other pneumoniae • Drowsiness under 2 years of age.
causes of fever.