1. Bushrah Khadim Anu Dhaliwal HDR presentation February 2016

2.  -20 Months old Joey was discharged from Paediatric Ward 4 days ago after a febrile convulsion.  -Mum wants to ask her GP some questions as she does not fully understand what happened.

3.  Febrile convulsions are benign, generalised convulsions or fits occurring in children aged 6 months to 5 years associated with fever and without any underlying cause.  Axillary temperature >37.8 or  Clinical hx and examination indicative of febrile seizure

4.  2% to 5% of European children  Atypical occurrences outside age range  Simple febrile seizure type most common  20% complex febrile seizures  5% status epilepticus  Multifactorial polygenic mode of inheritance with a maternal preponderance in transmission

5.  Mechanism unknown  Degree of fever or  Rate of rise of temperature  Genetic factors – strong family history

6.  Common causes are common  Viral illness  Otitis media  Tonsilitis  Gastroenteritis  Post immunisations

7.  Eyewitness account  Blood glucose  If the child has not yet recovered it is necessary to exclude more serious causes of convulsions such as meningitis or urinary tract infection.  An EEG is only indicated if there are repeated convulsions over a period of time, or a single atypical convulsion  persistent resultant neurological abnormality,  convulsion lasted more than 20 minutes  NICE – traffic light system

8.  Antipyretics  Avoid tepid sponging and excessive cooling  If a convulsion occurs place child in recovery position, do not put anything in their mouth.  Call for help if seizure lasting >5minutes  Repeated convulsions may be treated with rectal diazepam.  Advise for parents

9.  First febrile convulsion  Serious illness not excluded  Previous hx of febrile seizure with:  Child <18 months of age  Diagnostic uncertainty  Complex seizure – more likely to recur or due to intracranial infection

10.  The prognosis of febrile convulsions is good:  30% risk of recurrent febrile convulsions  10% risk of recurrence within the first 24 hours  the risk of long term epilepsy is 2-7%  Intellect not affected