Discussion on Febrile seizure by Dr. Puja Kapoor, at Sirsa.

Dr. Puja Kapoor, Pediatric neurologist, delivered lecture on, Febrile seizure and Clinical location of brain lesions , under the SPARS program, at Sirsa, Haryana.  It was an interactive session with the enthusiastic pediatricians of Sirsa.

  1. Definition of FS-
    A seizure occurring in a febrile child between the age of 6 to 60 months (above one month), who does not have any intracranial infection, metabolic disturbance or prior history of afebrile seizures
  2. What are the criteria for FS:
    • Temperature greater than 38 C
    • Age – usually 3 months to 6 years
    • No CNS infection or inflammation
    • No systemic or metabolic abnormality
    • No history of previous afebrile seizure
    • Neurologically healthy child.
  3. Febrile Seizures Definition : ILAE
    “A seizure occurring in childhood after 1 month of age, associated with a febrile illness not caused by an infection of the CNS, without previous neonatal seizures or previous unprovoked seizures”
  4. What are types of FS
                    • Simple:
                      1. Less than 15 minutes
                      2. Generalized (no focal features)
                      3. Not recurring within 24 hours
                    • Complex:
                      1. More than 15 minutes
                      2. Focal features or post-ictal paresis
                      3. May recur again within 24 hrs
  5. Evaluation…
    • Lumbar puncture: Not needed in a neurologically
      normal child, if fully immunized
      for Hemophilus & Pneumococcus.
    • EEG: Not needed after simple febrile seizure
    • MRI: Not needed after simple febrile seizures.
  6. Take home Message
      • Commonest type of seizures in children, in genetically predisposed, associated with fever
      • FS generally not associated with neurological consequences
      • There is no evidence of impact on learning abilities after seizure from SFS.
      • Limited indications for investigations including blood work, neuroimaging or EEG
      • Antipyretics & anticonvulsants: Prophylaxis decreases seizure recurrence but doesn’t reduce the risk of future epilepsy
      • Anaemia if present should be treated.
      • Counselling & reassurance of parents by care givers is the key in the management of the child
      • Family education is important.

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