Questions and Answers
What is a febrile seizure?
Which of the following are characteristics of a simple febrile seizure?
What characterizes a complex febrile seizure?
What are the clinical features of a febrile seizure?
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What should be considered when approaching a child with fever and first seizure?
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In 30-35% of children with meningitis, signs of meningeal infection are often present.
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What is the AAP Practice Guideline for first simple febrile seizure regarding lumbar puncture in children less than 12 months?
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Which of the following are risk factors for abnormal CSF in children with fever and seizures?
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EEG evaluation has predictive value in febrile seizures.
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Routine blood studies are recommended for children with febrile seizures.
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Neuroimaging is recommended for febrile seizures.
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What has research shown regarding the risk of death in febrile seizures?
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Long term intellectual dysfunction has been reported in children after febrile seizures.
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Study Notes
Febrile Seizures
- A febrile seizure occurs in children aged 6 months to 5 years, triggered by fever.
Simple Febrile Seizure
- Characterized as generalized without neurological deficits.
- Duration is less than 15 minutes.
- Only one seizure can occur within a 24-hour period.
Complex Febrile Seizure
- May involve focality or last longer than 15 minutes.
- Associated with neurological deficits.
- More than one seizure can occur within a 24-hour period.
Clinical Features of Febrile Seizure
- Typically occurs within the first 24 hours of fever.
- Triggered by rapid changes in body temperature, usually above 39°C (102.2°F).
- Frequently associated with recognizable infections, with viral upper respiratory infections being the most common trigger.
- 80% are classified as simple febrile seizures; 20% are complex.
- Seizures are mostly generalized motor, occasionally focal or non-motor such as staring or eye-rolling.
- Only 8% last longer than 15 minutes.
Approach to Child with Fever and First Seizure
- Consider febrile seizure, chronic seizure disorder triggered by fever, or intracranial infections like meningitis or encephalitis.
Meningitis and Seizures
- Seizures present in 13-16% of children with meningitis.
- In 30-35% of cases (especially in children under 18 months), meningeal signs may be absent.
AAP Practice Guideline for First Simple Febrile Seizure
- In children under 12 months, lumbar puncture (LP) is strongly recommended; optional for ages 12-18 months to rule out meningitis.
Risk Factors for Abnormal CSF in Kids with Fever and Seizures
- Physical exam findings suggesting concern.
- History of complex febrile seizures.
- Doctor visits within 48 hours prior to seizure.
- Arrival in the emergency department while seizing.
- Prolonged postictal state.
- First seizure occurring after age 3 years.
EEG Evaluation
- EEG is not predictive of febrile seizure outcomes.
Blood Studies
- Routine serum electrolytes, calcium, phosphorus, magnesium, CBC, or blood glucose not typically required.
Neuroimaging
- No necessity for skull films, CT scans, or MRIs in assessing febrile seizures.
Risk of Death
- Large studies indicate no reported deaths associated with febrile seizures.
Child Intelligence
- No evidence of long-term intellectual or neurological dysfunction following febrile seizures.
Epilepsy Development
- Slight increase in risk for developing epilepsy, but overall low incidence.
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Description
This quiz covers the essentials of febrile seizures, including their definitions, classifications, and clinical features. Learn about simple and complex febrile seizures, their triggers, and when they typically occur. Perfect for medical students and healthcare professionals looking to solidify their understanding.
