Questions and Answers
Which characteristic is true for complex febrile seizures?
What factors are associated with an increased risk of febrile seizures?
Which vaccination is notably linked with an increased occurrence of febrile seizures?
What is the age range during which febrile seizures typically occur?
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Which option describes the characteristics of simple febrile seizures?
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What typically does NOT contribute to the increased likelihood of febrile seizures?
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Which type of febrile seizure is least likely to require laboratory investigation?
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How does high fever predispose children to seizures?
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What indicates the performance of outpatient electroencephalography in children?
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Which treatment is appropriate when a seizure lasts longer than five minutes?
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What should be avoided during a child's seizure?
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Which of these is a risk factor for future unprovoked seizures after a febrile seizure?
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What is the role of ibuprofen and acetaminophen regarding febrile seizures?
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What could be administered when intravenous access is unavailable during a seizure?
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What parental instruction is essential after a seizure has stopped?
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What indicates a higher risk of recurrence after an initial febrile seizure?
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Which of the following statements about the characteristics of simple febrile seizures is accurate?
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Regarding complex febrile seizures, which characteristic is NOT true?
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What is a common misbelief about the use of EEG in the management of febrile seizures?
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Which of the following viruses is least likely to be associated with febrile seizures?
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Which of the following correctly describes the relationship between fever and neuronal excitability?
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Which vaccine is associated with an increased risk of febrile seizures?
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Which statement best represents the risk of developing conditions like bacterial meningitis in children with simple febrile seizures?
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What is the primary factor that determines the risk of febrile seizures in children?
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What is one reason why outpatient electroencephalography (EEG) should be performed in children?
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Which statement accurately describes the use of benzodiazepines in the context of seizures?
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What should parents be instructed to expect after their child experiences a seizure?
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Which of the following risk factors is associated with an increased risk of recurrence after an initial febrile seizure?
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Which of the following is NOT a recommended anticipatory guide for parents after a child's seizure?
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What is the role of antipyretics in managing febrile seizures according to a 2018 randomized trial?
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What is the stance on zinc sulfate supplementation in preventing febrile seizures?
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Which of these is a characteristic of risk factors for future unprovoked seizures after a febrile seizure?
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Study Notes
Febrile Seizures Overview
- Febrile seizures occur in children aged six months to five years, triggered by fever (≥ 100.4°F or 38°C) without central nervous system infection.
- They are the most common convulsive events in childhood, affecting 2% to 5% of children.
Types of Febrile Seizures
-
Simple Febrile Seizures:
- Duration: less than 15 minutes
- Generalized in nature
- No previous neurological issues
- Occurs once within 24 hours
-
Complex Febrile Seizures:
- Duration: 15 minutes or more
- Associated with focal neurological signs
- Recur within 24 hours
Risk Factors
- Common triggers include:
- Viral illnesses
- Certain vaccinations (e.g., MMR)
- Genetic predisposition
- Height of temperature elevation contributes to increased seizure risk, with rapid temperature rise also being a factor.
Mechanism Behind Seizures
- High fevers increase neuronal excitability, lowering the seizure threshold.
Associated Viruses and Vaccines
- Viruses linked with febrile seizures:
- HHV 6 (Roseola), influenza, adenovirus, parainfluenza
- Vaccines NOT associated with febrile seizures:
- Influenza vaccine and modern acellular pertussis vaccine.
Clinical Considerations
- Key historical features to assess include:
- Convulsion description and duration
- Personal/family seizure history
- Recent illnesses or vaccinations
- Todd paralysis refers to post-ictal weakness, often unilateral.
Diagnostic Approach
- Laboratory evaluations are not indicated for children with simple febrile seizures.
- Neuroimaging and EEG are generally unnecessary for complex febrile seizures; EEG only recommended for high-risk patients.
Management of Seizures
- Seizures lasting longer than five minutes can be treated with benzodiazepines.
- Alternative routes (buccal midazolam or rectal diazepam) are acceptable if intravenous access is unavailable.
- Antipyretics (ibuprofen, acetaminophen) may help reduce seizure recurrence risk.
Anticipatory Guidance for Parents
- Do not restrain the child or place objects in their mouth during a seizure.
- Position the child in a recovery position post-seizure and expect drowsiness.
- Seek emergency assistance if seizures exceed five minutes.
Recurrence and Future Seizure Risk
- Factors increasing risk of recurrence after initial febrile seizure include:
- Child younger than 18 months
- Febrile duration < 1 hour prior to seizure
- First-degree relative with a history of febrile seizures
- Body temperature < 40°C
- Risk factors for future unprovoked seizures post-febrile seizure:
- Age older than three years at first seizure
- Complex seizures
- Family history of epilepsy
- Neurodevelopmental abnormalities.
Febrile Seizures Overview
- Febrile seizures occur in children aged six months to five years, triggered by fever (≥ 100.4°F or 38°C) without central nervous system infection.
- They are the most common convulsive events in childhood, affecting 2% to 5% of children.
Types of Febrile Seizures
-
Simple Febrile Seizures:
- Duration: less than 15 minutes
- Generalized in nature
- No previous neurological issues
- Occurs once within 24 hours
-
Complex Febrile Seizures:
- Duration: 15 minutes or more
- Associated with focal neurological signs
- Recur within 24 hours
Risk Factors
- Common triggers include:
- Viral illnesses
- Certain vaccinations (e.g., MMR)
- Genetic predisposition
- Height of temperature elevation contributes to increased seizure risk, with rapid temperature rise also being a factor.
Mechanism Behind Seizures
- High fevers increase neuronal excitability, lowering the seizure threshold.
Associated Viruses and Vaccines
- Viruses linked with febrile seizures:
- HHV 6 (Roseola), influenza, adenovirus, parainfluenza
- Vaccines NOT associated with febrile seizures:
- Influenza vaccine and modern acellular pertussis vaccine.
Clinical Considerations
- Key historical features to assess include:
- Convulsion description and duration
- Personal/family seizure history
- Recent illnesses or vaccinations
- Todd paralysis refers to post-ictal weakness, often unilateral.
Diagnostic Approach
- Laboratory evaluations are not indicated for children with simple febrile seizures.
- Neuroimaging and EEG are generally unnecessary for complex febrile seizures; EEG only recommended for high-risk patients.
Management of Seizures
- Seizures lasting longer than five minutes can be treated with benzodiazepines.
- Alternative routes (buccal midazolam or rectal diazepam) are acceptable if intravenous access is unavailable.
- Antipyretics (ibuprofen, acetaminophen) may help reduce seizure recurrence risk.
Anticipatory Guidance for Parents
- Do not restrain the child or place objects in their mouth during a seizure.
- Position the child in a recovery position post-seizure and expect drowsiness.
- Seek emergency assistance if seizures exceed five minutes.
Recurrence and Future Seizure Risk
- Factors increasing risk of recurrence after initial febrile seizure include:
- Child younger than 18 months
- Febrile duration < 1 hour prior to seizure
- First-degree relative with a history of febrile seizures
- Body temperature < 40°C
- Risk factors for future unprovoked seizures post-febrile seizure:
- Age older than three years at first seizure
- Complex seizures
- Family history of epilepsy
- Neurodevelopmental abnormalities.
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Description
This quiz covers essential information about febrile seizures, specifically in children aged six months to five years. Topics include the definition, classifications, and characteristics of these seizures. Test your knowledge on how these seizures present and their implications.
