Conducted a CME at South Delhi On Febrile Seizure

Dr. Puja Kapoor,director & co-founder CONTINUA Kids, Consultant pediatric neurologist, conducted a CME at South Delhi, with South Delhi Women Pediatrician Group on \”What\’s new in febrile seizure(FS)?\”.It was an interactive session with the elite and well read audience.
the salient features of the discussion were-

                  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.