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…... 25-50% recurrence 3 risk factors…... 73-100% 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