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Benign Febrile Seizure: Pediatrics

This document defines benign febrile seizures in children, which are seizures caused by fever but without serious underlying conditions. It describes simple and complex febrile seizures, risk factors, treatments including antipyretics and anticonvulsants, and differential diagnoses such as meningitis or metabolic disorders. Neuroimaging and lumbar punctures are typically not needed for simple febrile seizures but may be used to rule out other conditions causing the fever and seizures.

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Krista P. Aguinaldo
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115 views2 pages

Benign Febrile Seizure: Pediatrics

This document defines benign febrile seizures in children, which are seizures caused by fever but without serious underlying conditions. It describes simple and complex febrile seizures, risk factors, treatments including antipyretics and anticonvulsants, and differential diagnoses such as meningitis or metabolic disorders. Neuroimaging and lumbar punctures are typically not needed for simple febrile seizures but may be used to rule out other conditions causing the fever and seizures.

Uploaded by

Krista P. Aguinaldo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Pediatrics

Benign Febrile Seizure


Definition: • strongly recommended in infants <1 yr of
Simple Febrile seizure age because other signs of the infection
• Seizure occurring in healthy children ages 3months might not be present
-5 years, Axillary temperature of 37.8°C or more, • Considered for children 12-18months: symptoms
Characterized as generalized tonic-clonic, Lasting for may be subtle
less than 15minutes,Does not recur within the same • Indicated for children >18 mo
febrile illness (within 24 hours). • in the presence of clinical signs and
• More common than CFS symptoms of meningitis
Complex Febrile seizure • history and/or physical exam otherwise
 Difference with SFC is: suggest intracranial infection.
o Last longer than 15 minutes • Benefits: Meningeal signs and symptoms strongly
o Occurs more than once within 24 hours suggest meningitis, which, if bacterial in etiology, will
o Focal seizures likely be fatal if left untreated.
Epidemiology: • Harms/risks/costs: Lumbar puncture is an invasive
 Prevalence of SFS in the Philippines is UNKNOWN and often painful procedure and can be costly.
 One of the most frequent cause of emergency room NEUROIMAGING
consultations and even hospital admissions locally • Cranial Ultrasound, CT scan, and or MRI
Pathophysiology: • Neuroimaging studies should not be
• The pathophysiology of febrile seizures is routinely performed in children for simple
incompletely understood. febrile seizure.
• But family history suggest genetic susceptibility IMMEDIATE MANAGEMENT
• The role of activation of the cytokine. • Maintain airway with O2 therapy;
• Cytokines are proteins that affect the parts • Anticonvulsants as necessary
of the nervous system responsible for • Oral/IV/Rectal diazepam
regulating body’s temp. their release causes • ANTIPYRETICS
a rise in body’s temp • decrease the discomfort of the child
• Increased susceptibility to febrile seizures associated • do not reduce the risk of having a recurrent
with interleukins. febrile seizure
• It is possible that circulating toxins and • because the seizure often occurs as the
immune reaction products modulate temperature is rising or falling.
neuronal excitability. One study showed • ANTIEPILEPTIC THERAPY
that in the presence of viral RNA, the • acute treatment with diazepam, lorazepam,
leukocytes of children who had febrile or midazolam is needed.
seizures produced significantly more • IV phenobarbital, or valproate may be
interleukin-1β than did those of healthy needed in the case of febrile status
controls, and interleukin-1β may promote epilepticus.
hyperthermia-induced seizures • Continuous anticovulsant is not
Work-ups recommended in children after a SFC.
• History • The adverse side effects of these do not
• Physical Exam warrant their use in benign disorder.
• Diagnostics Childhood Vaccines and Febrile Seizures
• Laboratories • Vaccines can sometimes cause fevers, but febrile
• No specific studies are indicated seizures are uncommon after vaccination.
for a simple febrile seizure. • There is a small increased risk for febrile seizures
• Physicians should focus on after MMR and MMRV vaccines.
diagnosing the cause of fever. • There is a small increased risk for febrile seizures
• Lumbar puncture when influenza (flu) vaccine is given at the same
Lumbar Puncture: doctor visit as either the PCV13 vaccine or the DTaP
• Recommended in children <12 mo to rule out vaccine.
meningitis

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• Essential update: Starting MMR/MMRV vaccination • Repeated seizures wherein the patient does not
earlier may reduce seizure risk regain consciousness in between attacks, Always an
Medical Emergency

ADD ONS DIFFERENTIAL DIAGNOSIS

Terminologies
Metabolic disorders causing seizures: 
SEIZURES: Paroxysmal time limited changes in motor activity • Metabolic disorders causing seizures refers to
and/or behavior that result from abnormal brain activity convulsions caused by a disorder that affects the
CONVULSION: Only a type of seizure which is seen as body's vital chemical processes (metabolism)
motor movements Electrolyte disturbances (altered levels of sodium,
EPILEPSY: Present when 2 or more unprovoked seizures occur calcium, or magnesium)
at an interval greater than 24 hours apart Hypoglycemia (low blood sugar)
Hyperglycemia (elevated blood sugar)
TYPES OF SEIZURE:
A. Generalized Seizures: Involves both side of the brain
CNS INFECTION PROBABLY BACTERIAL MENINGITIS
Consciousness involved
• A clinical syndrome characterized by inflammation of
 Tonic Seizure
the meninges
o (+) Rigid extension of the trunk and
• Triad of fever, headache, and neck stiffness
extremities with facial spasms , (+) usually
with LOC RULE IN RULE OUT
 Clonic Seizure FEVER NO meningeal signs (nuchal
o (+) Extremities are seen to have jerky rigidity)
movements, (+) usually with LOC SEIZURE No altered level of consciousness
 Tonic-Clonic Seizure History of cough and
o Abrupt usually with a cry, Falls – LOC – Tonic colds
Spasm,(+) upward rolling of eyes, Inc VS, Dil
Pupils, (+)Lose control of bladder/bowel, (+)
Exhaution after
 Absence Seizure
o Common in school aged children, Sudden
and brief, (+) sudden cessation of activity,
Blank stare, (+) blinking, fidding, lip
smacking
 Myoclonic Seizure
o Pt. may be aware that there is a repeated
quick jerky movements of one or both
extremity.
 Atonic Seizure
o Sudden lose control of muscle tone
B. Partial Seizure: Involves one part of the body indicating
involvement of one part of the Brain
• Simple Partial Seizure
• The pt. is conscious and aware
• May have the ff. seizure type
• Motor movements
• Sensory symptoms
• Complex Partial Seizure
• there is associated LOC
C. Unclassified Epileptic Seizures
D. Status Epilepticus
• Seizures that last > 30mins of continuous seizure

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