Ordinarily seen in childhood, these are generalized tonic-clonic seizures with the following characteristics:
- They occur in children aged between 6 months and 5 years,
- There is fever at the time of the attack (usually greater than 38°C),
- They are of brief duration (always less than 15 minutes),
- They occur in the absence of central nervous system infection, and
- There is absence of neurological abnormalities in the inter-ictal period.
Evaluate to find the cause of the fever if not determined by physical examination:
- Blood slide for MPs
- Full blood count
- Lumbar puncture and CSF examination – Strongly recommended in all infants or children who have received antibiotics
- Blood for culture
- Emergency care:
- Give paracetamol to reduce the temperature.
- Reduce child’s clothing to a minimum to facilitate lowering of temperature.
- Give rectal diazepam if child is convulsing at the time of presentation.
- Treat identified cause.
- Subsequent care:
- Educate parents that recurrences are common but that they can be reduced by administration of antipyretics as soon as child becomes febrile. Diazepam may be used occasionally.
- Anticonvulsants should be used regularly after the second or third attack of the febrile convulsions or if the convulsion is atypical.
- Seizures in the neonate are covered under neonatal care.