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.