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Febrile convulsions (Pathophysiology (No prior neuro disease or focal…
Febrile convulsions
Pathophysiology
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Rapid rise in temp causes the seizures, can reach high temp (>39 degrees) that may have reduced by the time assessed
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Higher risk of epilepsy if prolonged seizures, unilateral, recur <24h, baseline neurological abnormalities
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Types
Complex/atypical febrile
Focal, prolonged (>15m) or multiple/day
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Diagnosis
Examination
Cardio: CRT, new murmur
Resp: cough, crackles, breath sounds
Abdo: tender, distended
Neuro: reduced GCS, stiff neck, seizures
Derm: rashes
Investigations
Bedside
Obs: sats, RR, HR, BP, temp
Bloods
FBC, CRP/ESR, U+E, LFTs
cultures, serology
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History
PC/HPC: stiff neck, low GCS, abdo pain, cough, rash
PMH: previous convulsions, immunizations
DH: recent medications, allergies
SH: contacts who are ill
Management
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Definitive
Medical
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Anticonvulsants
Indication: status (>10min)
E.g. lorazepam IV, buccal midazolam, diazepam PR
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