اللجنة العلميةـ دفعة الشهيد يحيى السنوار 28 طب بشري UST

~•°• Febrile convulsion °••°Definition : convulsion in age vulnerable children (6months -6 years) due to: - rapid rise of body temperature - due to extracranial causes (mostly viral) °••° Incidence: - 4% of children - familiar (20%) - recurrent (30-50% specially in those with family history) - The risk of subsequent epilepsy is not substantially greater than that for the general population (approximately 2%). °••° Diagnostic criteria: - age = 6months - 6 years - temperature = Usually > 39°C (fits occur within 8-12hrs from onset of fever) - No evidence ofCNS infection (e.g. meningitis, abscess) - Evidence of extracranial infection (e.g. tonsillitis, otitis media, roseola) - no previous history of afebrile seizures °••° Types of convulsion °°typical (simple) - Generalized tonic-clonic. - Last< 15 min. - One fit only in the same illness. - The commonest form °°complex -Focal -Last> 15 min - Recurring during the same illness -Uncommon. -Febrile status epilepticus is a febrile seizure lasting >30 min °••°investigations * Usually not needed in children with simple febrile convulsion. * For complex form: - blood glucose -serum electrolyte - toxicology screen - LP - CT scan , MRI - EEG °••° Rx for simple type - control the fever *paracetamol 10-20 mg/kg *cold bath - treatment of seizures if persist - Ab - Parent advice about fever control - iron supplement-> Iron deficiency has been shown to be associated with an increased risk of febrile seizures °••°DDx From other causes of convulsions with fever : 1- Meningitis. 2- Viral meningeo encephalitis (commonly herpes simplex) 3-Brain abscess. 4- Epileptic fit precipitated by associated fever