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    Febrile Seizures

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    Lita Al Amudi
    1. Febrile seizures are seizures that occur in children between 3 months and 5 years of age during a febrile illness but without an infection of the central nervous system. 2. Febrile seizures are classified as either simple or complex, with complex seizures having features like a duration over 15 minutes or focal onset. 3. Diagnosis of febrile seizures involves a history, physical exam, lab tests if indicated, and brain imaging or EEG only if abnormalities are detected on exam. Treatment differs depending on the duration and type of seizure.

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    Febrile Seizures

    Uploaded by

    Lita Al Amudi
    77 views11 pages
    1. Febrile seizures are seizures that occur in children between 3 months and 5 years of age during a febrile illness but without an infection of the central nervous system. 2. Febrile seizures are classified as either simple or complex, with complex seizures having features like a duration over 15 minutes or focal onset. 3. Diagnosis of febrile seizures involves a history, physical exam, lab tests if indicated, and brain imaging or EEG only if abnormalities are detected on exam. Treatment differs depending on the duration and type of seizure.

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    1. Febrile seizures are seizures that occur in children between 3 months and 5 years of age during a febrile illness but without an infection of the central nervous system. 2. Febrile seizures are classified as either simple or complex, with complex seizures having features like a duration over 15 minutes or focal onset. 3. Diagnosis of febrile seizures involves a history, physical exam, lab tests if indicated, and brain imaging or EEG only if abnormalities are detected on exam. Treatment differs depending on the duration and type of seizure.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    77 views11 pages

    Febrile Seizures

    Uploaded by

    Lita Al Amudi
    1. Febrile seizures are seizures that occur in children between 3 months and 5 years of age during a febrile illness but without an infection of the central nervous system. 2. Febrile seizures are classified as either simple or complex, with complex seizures having features like a duration over 15 minutes or focal onset. 3. Diagnosis of febrile seizures involves a history, physical exam, lab tests if indicated, and brain imaging or EEG only if abnormalities are detected on exam. Treatment differs depending on the duration and type of seizure.

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    of 11

    FEBRILE SEIZURES

    dr. Hadia Angriani, SpA

    SUB. BAGIAN NEUROLOGI ANAK BIKA FK UNHAS / RS Dr. WAHIDIN SUDIROHUSODO

    A. DEFINITIONS
    Two operational definition of febrile seizure have been published:
    1.

    From a National Institutes of Health Consensus Conference (1980):

    Febrile seizures : a febrile seizures is an event in infancy or


    childhood, usually occurring between 3 month & 5 years of

    age, associated with fever but without evidence of intracranial infection or defined cause

    2. From International League Against Epilepsy Commission on epidemiology & prognosis (1993) : Febrile seizures : A seizures occurring in childhood after

    age 1 month, associated with a febrile illness not caused


    by an infection of the CNS without previous neonatal seizures or a previous unprovoked seizures, & not meeting criteria for other acute symptomatic seizures Neither definition includes a specific criteria on as to what temperature defines fever. A temperature of at least 38.40C (1010F) would probably be accepted by most authorities & Has been utilized in many epidemiological studies.

    B. CLASSIFICATION & CLINICAL MANIFESTATIONS


    Febrile seizures are typically divided into two types, simple & complex. 1. A complex febrile seizures has one or more of the following features (Commission 1993) : a. Partial onset or focal features during the seizures. b. Prolonged duration (> 10 minutes or > 15 minutes). c. Recurrent febrile seizures within 24 hours of the first episode.

    2. A simple febrile seizures consist of less than 10 or 15


    minutes of generalized tonic-clonic activity, resolving spontaneously, in the context of a febrile illness,

    without focal features or recurrence during the subsequents


    24 hours

    C. DIAGNOSTIC PROCEDURE
    1. Laboratory investigations : Many laboratory studies have been shown to be

    unhelpful in the management of the child with


    febrile seizures, except when specific symptoms or signs (e.g-vomiting or diarrhea) exist. Lab. study include : a complete blood count, blood sugar, serum electrolytes, serrex calcium,

    phosphorus, magnesium, blood urea nitrogen


    levels & urinalysis

    2. Brain imaging CT scan or MRI is indicated in a child who has had a febrile seizures : a. When the history or examination indicates possible or hemotympanum) b. If the examination points to a possible structural brain Lession (e.g. microcephaly, spasticity) c. With evidence of increased intracranial pressure (persisting irritability or drowsiness recurrent vomiting,

    Definite head trauma (e.g.scalp swelling & discoloration,

    fullness of the anterior funtanelle in the young child,


    cranial nerve VI palsies, or papilledema in the older child)

    3. EEG Electroencephalopathy (EEG) is of limited value in the management of febrile seizures despite the fact that epilepsy form activity on an EEG is seen in 2 86 % (average 25%) of these children)

    D. DIAGNOSIS
    Diagnosis was made base on : History Examination Laboratory investigation Brain imaging and EEG

    E. DIFERENTIAL DIAGNOSIS
    CNS infection

    Intracranial proses
    Sinkop Children with high fever

    BAGAN PEMBERANTASAN KEJANG


    KEJANG

    0-5 menit 1

    (A) Diazepam IV : 0,2-0,5 mg/kgBB atau Diazepam rektal : BB < 10 kg = 5 mg BB > 10 kg = 10 mg


    2

    KEJANG (-)

    KEJANG (+)
    (A) Dapat diulang 2 kali interval 5 menit

    5-10 menit (B) OAE sesuai kebutuhan : Kejang demam / infeksi SSP Epilepsi KEJANG (-) Fenitoin : 6 jam kemudian 5 7 mg/kg BB ditambah (B) 10-15 menit KEJANG (-) KEJANG (+) Phenobarbital IV/IM 12 jam kemudian 3-4 mg/kgBB ditambah (B) Phenobarbital IV/IM 10-20 mg/kgBB KEJANG (+) KEJANG (+)

    Fenitoin Bolus IV 15-20 mg/kgBB Kecepatan : 25 mg/menit

    ICU Midazolam : 0,2 mg/kgBB Phentobarbital 5-10 mg/kgBB

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