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level: Level 1

Questions and Answers List

Febrile Seizures

level questions: Level 1

QuestionAnswer
Fever with fit (3months - 6years) Brain doesnt fully developed yet Genetic predisposition Usually occur with sudden rise of temperature Benign event with good prognosis No neurological deficit Not affecting intelligenceWhat is febrile seizure? How do we explain febrile seizure to parents?
1. stay calm & dont panic 2. loose cloth esp around neck 3. left lateral position 4. wipe any secretion 5. dont put anything inside the mouth 6. take note the duration 7. during fever, do tepid sponging, encourage fluid intake, good aeration 8. can record video if availableAdvice to parents regarding management of febrile seizure at home
1. first time, recurrent? 2. pre ictal - what is pt doing before, aura? crying, irritability? 3. ictal - focal or GTC? uprolling of eyeball, jerking of arm & legs, spasm of peripheries, drooling of saliva, duration 4. post ictal - drowsiness, consciousness? 5. family hx of febrile seizure - 1st degree? 6. Ruling out cause of infection - acute tonsilopharyngitis, otitis media, URTI, UTIhx of febrile seizure
1. Rule out acute meningitis - irritability, high pitch cry, neck stiffness, projectile vomiting, poor feeding, seizure - focal, >15mins, recurrent 2. Electrolyte imbalance - Na, PO4, Mg, Ca, K (not usually) 3. Hypoglycemia - last meal? known DM? 4. Perinatal infection - intrauterine infection, trauma during pregnancy 5. Febrile fit is diagnosis of exclusionPatient came with fever and fit. Differential diagnosis?
General: general built, BMI, syndromic features?, normal w & h? sign of neurocutaneous stigmata, hydration status Neuro examination UL, LL - tone, power, reflex cranial nerve, sensory otoscope -if otitis media fundoscope - evidence of papilledimaPE of febrile seizure
1. fbc - wbc 2. rp - check for electrolyte imbalance 3. urine c+s - to rule out UTI 4. blood c+s - identify organism of infection 5. random blood glucose - to rule out hypoglycemia 6. EEG 7. Sign of meningism - LPIx of febrile seizure
1. tepid sponging 2. fit chart 3. syrup PCM 15mg/kg 4. i/o chart 5. fit education/diarymx of febrile seizure