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 y

With T>38°c or more

Not 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.o

In children has received A/B

Signs 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