Case 41: Febrile Seizure

If a febrile seizure lasts longer than 5 minutes, what medications can be given?

A benzodiazepine such as lorazepam or diazepam

What is the definition of a febrile seizure?

A seizure that occurs in the absence of CNS infection with elevated temperature in a child between the ages of 6 months and 6 years

How long is a simple febrile seizure?

A simple febrile seizure is less than 15 minutes long and does not have lateralizing signs

What is the definition of a seizure?

Abnormal electrical activity in the brain resulting in altered mental status and involuntary neuromuscular activity

Between what ages do febrile seizures typically occur?

Between 6 months and 6 years of age

What are the two classic physical findings that suggest meningeal irritation?

Brudzinskis and Kernigs sign

If a 2 year old child has a temperature of 104 and has a generalized tonic clonic seizure, what is the most likely diagnosis?

Febrile seizure

If the benzodiazepine doesn't seem to help what other medication can be tried?

Fosphenytoin

When should a lumbar puncture be performed on a patient with febrile seizures?

In cases where the child is younger than one year and the meningeal signs are not reliable

What is the best management for a child with a febrile seizure?

Parental education, injury prevention during seizures, and fever control

What is the definition of epilepsy?

Recurrent seizure activity

What is the expected course for a patient with febrile seizures?

The patient is expected to grow out of his seizures by the time that he is 5 or 6, but until then he may have more febrile seizures

What is Kernigs sign?

The patient is supine with the knees and hips flexed, and then pain is induced when the legs are straightened

What is Brudzinski sign?

When a patient is lying supine their neck is flexed which results in involuntary flexion of the knee and hip

If a child has a febrile seizure will they likely have another?

Yes, there is a 50-65 percent chance of developing another if the patient is under one, and if the patient is over one the chances are between 20 and 30 percent