1. Febrile Convulsion
Dr F. Ashrafzadeh
3/7/90

2. Definition of F.C Occur between 6 mo – 6 y With T>38°c or more
Not result of CNS infectious or metabolic dis..
Incidence: 2-5%

3. Classification: Simple F.C Complex F.C
>15’ , focal, recur within 24 hr
Febrile status epilepticus
>30'

4. Recurrence of F.C 30% after a first episode
50% after 2 or more episode or
in infant less than 1 years

5. Risk factors for recurrence of F.C
Major:
Age < 1 y
Duration of fever< 24 hr
Fever 38-39°c
Minor:
Familial hx of F.C Day care
Familial hx of epilepsy Male
Complex F.C Low Na

6. Risk factors for recurrence of F.C
con’t:
1 risk factor……. 12% recurrence
2 risk factors… % recurrence
3 risk factors… % recurrence

7. Types of epilepsy can be preceded by F.C:
Severe myoclonic epilepsy of infancy
( Dravet syndrome )
Generalized epilepsy with F.C
( GEFS+)
Temporal lobe epilepsy
( mesial temporal sclerosis )

8. GEFS+:
A.D syndrome
Early childhood
Generalized epilepsy
(GTCS, absence, myoclonic
atonia, myoclonic astatic)

9. Dravet syndrome: Severe form of epilepsy Onset in 1st year of life
Febrile or afebrile unilateral clonic seizures
During 2 yrs seizure occur
Makes developmental delay
A.D gene is located 2q24-31
Most patients with vaccine encephalopathy
have Dravet syn

10. Risk factors for recurrence of epilepsy
Simple F.C 1% Developmental delay 33% Focal complex F.C 29% Familial hx of epilepsy 18% Fever 1 hr before attacks 11% Complex febrile seizures 6% Recurrent F.C 4%

11. Lumbar puncture:
In children less than 18 m.o In children has received A/B Signs and symptoms of meningitis

12. EEG in F.C: When epilepsy is highly suspected
To know the type of epilepsy
It can’t delineate F.C occurrence
Must be done after 2 weeks

13. Paraclinical studies:
Blood studies is not recommended
unless…..
B.S if prolonged postictal obtundation
Neuroimaging is not recommended

14. Treatment: If seizure last more than 5 minutes….. give DZM
Oral DZM 0.3 mg/kg q8h during fever
Chronic antiepileptic therapy in greater risk group
Iron deficiency increases F.C