FEBRILE CONVULSIONS

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.

Investigations

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

Management

  • 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.