brief (
TRANSCRIPT
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Brief (<15 min), generalized, tonic-clonic seizure associated with a febrile illness, but without any CNS infection, severe metabolic disturbance, or other known neurological cause
The most common seizure disorder during childhood
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Age: 6 m/o ~ 5 y/o Incidence: 2% ~ 4% in children
<5 y/o Peak age of onset: 18 ~ 22 m/o Sex: male = female Strong family history in siblings and pa
rents: increase risk 2~3 times
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Viral URI Reseola Acute otitis media
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80~90% of cases Occur early when core
temperature reaches 39 C or greater
Generalized, tonic-clonic for seconds to 15-min, followed by a postictal period of drowsiness
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Age < 6 m/o or > 5 y/o Onset >24 hr after fever onset Duration >15 min Occur more than once in 24 hr Focal motor manifestations Abnormal neurological
examination
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Typical: not required Atypical: required
• EEG• Toxicology screening• Assessment of electrolytes• CT or MRI
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Routine treatment:• Search for the cause of fever• Control fever (avoid excessive clothing, encourage fluids, tepid sponge bath, and antipyretics)
Prophylactic anticonvulsants are not indicated for typical febrile convulsion
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Excellent prognosis in most children
Risk of recurrence:• Onset < 1 y/o or with family history: 50%
• Onset > 1 y/o: 30 % up to the age of 5 yr
• After second episode: 50 %• Age > 5 y/o: near zero
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Risk of epilepsy development:• 1~2% in the general population
• increase up to 9% when two or more risk factors are present
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Risk factors for epilepsy development:• Positive family history of epilepsy• Atypical febrile convulsion• Previous abnormal development or neurological disorder
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Antipyretic agents: ineffective Diazepam: effective and safe
• Oral or rectal form• For patients with frequent febrile convulsion or significant parental anxiety
• Dose: 0.3 mg/kg q8h PO (1 mg/kg/d) for the duration of the illness (2~3 days)
• Side effects: lethargy, irritable, ataxia
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Thank You for Your Attention
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