Febrile Seizures – Common dilemmas

  1. When do we need a Lumbar puncture?
    • Clinical sign and symptom of meningitis
    • Seizure with fever in a child who has received antibiotics earlier during that illness
    • Infants between age group 6-12 month who are NOT immunized for H Influenza and S. Pneumococcus
  2. Do we need neuroimaging ? And what is the right time to do it?
    • Neuroimaging should not be performed as a routine for a simple febrile seizure
    • Urgent neuroimaging is not recommended for patients with complex febrile seizures. A MRI can be planed later  on a OPD basis for cases with focal and prolonged febrile seizures. 
    • CT head is unlikely to give good information
  3. Role of EEG in febrile seizure
    • EEG Is not advised as a routine in simple febrile seizures
    • EEG is useful in febrile seizures which are focal or prolonged (>10 minutes) and in those patients who have abnormal neurological examination. 
    • Urgent EEG is advisable for prolonged loss of consciousness after a seizure with fever.
    • In cases of complex febrile seizures, an early EEG (<7 days) has been shown to pick up abnormalities more commonly than late EEG. In case the early EEG is abnormal, a repeat the EEG is done after one to three months. 

Coming up …. Family Counseling issues on 15/12/19.

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