Simple Febrile Convulsion

Febrile convulsion the most common seizure disorder during childhood 3 month .6 yr of age strong family history of febrile convulsion .

8C or greater generalized and tonicclonic seizure Lasts for less than 15 minutes Not recur within the same febrile illness Neurologic examination is normal No underlying CNS infection duration is >15 min repeated convulsions occur within 24 hr focal seizure activity or focal findings are present during the postictal period .Simple Febrile convulsion       Complex Febrile Convulsion    Temperature of 37.

Definition Grades of Recommendation Grade A: Diagnostic test should be used Grade B: The test may or may not be used Grade C: The test should not be used .

For children more than 18 months of age.Diagnosis of Febrile Convulsion RECOMMENDATION ON NEURODIAGNOSTIC PROCEDURES   Lumbar puncture should be performed in all children below 18 months for a simple febrile seizure. lumbar puncture should be performed in the presence of clinical signs of meningitis Grade of Recommendation: A Level of Evidence 3 .

lumbar puncture for CSF analysis is performed to rule out meningitis CSF analysis is the gold standard for diagnosis of meningitis Spinal fluid examination is not a test that makes a diagnosis of febrile seizures per se Major signs of meningitis Nuchal rigidity Coma Petechiae Minor signs of meningitis  Persisting drowsiness  Paralysis on examination .RECOMMENDATION ON NEURODIAGNOSTIC PROCEDURES ACCURACY OF TEST Children with febrile seizures.

RECOMMENDATION ON NEURODIAGNOSTIC PROCEDURES Neuroimaging studies (cranial ultrasound. MRI) should not be routinely performed in children for a simple febrile seizure No study has been done investigating the utility of neuroimaging in children with simple febrile seizure Grade of Recommendation: C Level of Evidence: 4 . CT scan.

Treatment of Febrile Convulsion RECOMMENDATION ON THERAPEUTIC INTERVENTION  Antipyretic agents are used to control fever and not be relied upon to prevent recurrence There is little evidence that prophylactic use of antipyretics has any effect in reducing the incidence of febrile convulsion Acetaminophen(10 mg/kg/dose) and ibuprofen (5 mg/kg/dose) are effective antipyretic agents Little evidence that use of antipyretics has any effect in reducing the incidence of febrile convulsion Grade of Recommendation: C Level of Evidence: 2 .

the adverse side effects of these do not warrant their use in this benign disorder .RECOMMENDATION ON THERAPEUTIC INTERVENTION  Use of continuous anticonvulsant is not recommended in children after a first simple febrile seizure. Although anticonvulsants can reduce recurrence of febrile convulsion.

Prognostic Evaluation Electroencephalogram should not be routinely requested in children with a first simple febrile convulsion  Evidences show that it does not reliably predict recurrence of febrile seizure .

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