Febrile Convulsion
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Transcript of Febrile Convulsion
Febrile ConvulsionFebrile Convulsion
Dr F. AshrafzadehDr F. Ashrafzadeh
3/7/903/7/90
Definition of F.CDefinition of F.C
Occur between 6 mo – 6 yWith T>38°c or moreNot result of CNS infectious or metabolic dis..
Incidence: 2-5%
Classification:
Simple F.C Complex F.C >15’ , focal, recur within 24 hr Febrile status epilepticus >30'
Recurrence of F.C
30% after a first episode
50% after 2 or more episode or in infant less than 1 years
Risk factors for recurrence of F.CRisk factors for recurrence of F.C Major: Age < 1 y Duration of fever< 24 hr Fever 38-39°c Minor: Familial hx of F.C Day care Familial hx of epilepsy Male Complex F.C Low Na
Risk factors for recurrence of F.CRisk factors for recurrence of F.C
con’t: 1 risk factor……. 12% recurrence 2 risk factors…... 25-50% recurrence 3 risk factors…... 73-100% recurrence
Types of epilepsy can be preceded by F.C:
Severe myoclonic epilepsy of infancy ( Dravet syndrome ) Generalized epilepsy with F.C ( GEFS+) Temporal lobe epilepsy ( mesial temporal sclerosis )
GEFS+:GEFS+:
A.D syndrome Early childhood Generalized epilepsy (GTCS, absence, myoclonic atonia, myoclonic astatic)
Dravet syndrome:Dravet syndrome:
Severe form of epilepsy Onset in 1st year of life Febrile or afebrile unilateral clonic seizures During 2 yrs seizure occur Makes developmental delay A.D gene is located 2q24-31 Most patients with vaccine encephalopathy have Dravet syn
Risk factors for recurrence of epilepsyRisk factors for recurrence of epilepsy
Simple F.C 1%Developmental delay 33%Focal complex F.C 29%Familial hx of epilepsy 18%Fever 1 hr before attacks 11%Complex febrile seizures 6%Recurrent F.C 4%
Lumbar puncture:Lumbar puncture:
In children less than 18 m.oIn children has received A/BSigns and symptoms of meningitis
EEG in F.C: When epilepsy is highly suspected
To know the type of epilepsy
It can’t delineate F.C occurrence
Must be done after 2 weeks
Paraclinical studies:Paraclinical studies:
• Blood studies is not recommended unless…..•B.S if prolonged postictal obtundation
•Neuroimaging is not recommended
Treatment:Treatment:
If seizure last more than 5 minutes….. give DZM
Oral DZM 0.3 mg/kg q8h during fever
Chronic antiepileptic therapy in greater risk group
Iron deficiency increases F.C