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Febrile convulsion

Medicine > Neurosciences

Background knowledge 🧠

Definition

  • Febrile convulsions, also known as febrile seizures, are convulsions associated with a high body temperature (fever), but without an underlying central nervous system infection.
  • They are the most common type of seizures in children.

Epidemiology

  • Typically occur in children between the ages of 6 months and 5 years.
  • There is a slight male predominance.

Aetiology

  • The exact cause is unknown, but they are thought to be related to the rapid increase in body temperature rather than the absolute value of the fever.
  • Often occur with common childhood illnesses like ear infections, colds, and viral infections.

Types

  • Simple Febrile Convulsions:
    • More common.
    • Generalised seizure lasting less than 15 minutes.
    • Does not recur within 24 hours or a febrile illness.
  • Complex Febrile Convulsions: Last longer than 15 minutes, occur more than once during a febrile illness, or are focal in nature.

Clinical Features 🌡️

Clinical Features

  • Seizure occurring in the context of a febrile illness.
  • Loss of consciousness and convulsions (jerking movements).
  • Postictal drowsiness or confusion may follow.

Investigations 🧪

Tests

  • Clinical diagnosis based on history and presentation.
  • Exclusion of central nervous system infection (e.g., meningitis) is crucial, especially in complex cases or if there are any atypical features.
  • Lumbar puncture may be required in certain cases to rule out meningitis, especially in infants.

Management 🥼

Management

  • Treatment is directed at the febrile illness and maintaining safety during seizures.
  • Antipyretics can be used to control fever.
  • Antiepileptic drugs are generally not recommended for simple febrile convulsions.
  • Parental education about managing future seizures and when to seek medical attention.

Prognosis

  • Generally good, with most children outgrowing the tendency to have febrile convulsions by the age of 5.
  • Simple febrile convulsions do not cause brain damage and have a low risk of developing into epilepsy.

Key Points

  • Febrile convulsions (simple/complex) are associated with a fever, but without an underlying central nervous system infection.
  • Patient often presents with a seizure occurring in the context of a febrile illness.
  • Diagnosis is primarily clinical (history and examination), with exclusion of central nervous system infection.
  • Treatment is directed at the febrile illness and maintaining safety during seizures.

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Neurosciences