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Febrile Seizures PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Febrile Seizures" by Katie Doran, DO FAAP.
This medical PowerPoint presentation talks about Febrile seizures.
Febrile seizures are seizures that occur in children aged between 6 months and 5 years, usually as a result of a fever. They are the most common type of seizure in children and typically last for less than 5 minutes.
The exact cause of febrile seizures is not fully understood, but it is believed that they are triggered by the rapid rise in body temperature that can occur during a fever. Children who have a family history of febrile seizures or who have experienced them before are more likely to have them again.
Febrile seizures can be scary for parents to witness, but they are usually not harmful to the child and do not cause any long-term damage. It is important to keep the child safe during the seizure by making sure they are lying down and cannot harm themselves. After the seizure, the child should be evaluated by a healthcare provider to determine the cause of the fever and to monitor for any complications.
Treatment for febrile seizures usually involves controlling the fever with acetaminophen or ibuprofen. In some cases, anticonvulsant medications may be prescribed to prevent future seizures. Parents should always follow their healthcare providers instructions for managing their childs fever and seizures.

Tags : Febrile seizures, Child Neurology, Child Neurology PowerPoint presentation, Neurology PowerPoint presentation

Published on : Mar 21, 2023 | Views : 2252 | Downloads : 0

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Slide 1-

SPUC Weekly WebinarFebrile Seizures Katie Doran, DO FAAP Division of Urgent Care Children's Mercy Hospital
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Disclosures 2 I have no disclosures
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Learning Objectives Identify a febrile seizure and its subtypes Understand treatment of febrile seizures specific to urgent care Explore Evidence Based Practice guidelines for febrile seizures at Children's Mercy Educate families on Seizure First Aid 3
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Case Presentation CC: Seizure HPI: 2 year old female who presented actively seizing which started while she was shopping for a new fish at the pet store +Cough and congestion for a few days, no recent fevers History of 6 febrile seizures in the past presenting as upper and lower extremity twitching Family is thinking about seeing Neurology as they are becoming more frequent 4
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Febrile Seizures 5 Occur in about 4% of children ages 6 – 60 months in association with a febrile illness Most common form of seizures and neurological disorder in children 30-40% will have at least one reoccurrence General population risk of epilepsy 0.5-1%, risk in patients with febrile seizures is 1-2%.
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Febrile Seizures Simple Symmetric Lasts less than 15 minutes (most <5) Only one seizure associated with febrile illness/24 hour timeframe Complex Focal features during or after event Lasts more than 15 minutes More than 1 seizure in a 24 hour period 6
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Febrile Seizures and Epilepsy 7 Dravet Syndrome (severe myoclonic epilepsy of infancy) Often prolonged and asymmetric, progressive and starts to occur without fevers Generalized Epilepsy with Febrile Seizures Plus (GEFS+) Autosomal dominant syndrome Febrile seizures can disappear by age 6, others can go on to have continued febrile seizures over age 6 and other seizure types
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Clinical Practice Guidelines 8 Simple Febrile Seizure Complex Febrile Seizure
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CPG Simple Febrile Seizure 9
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CPG Simple Febrile Seizure 10
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CPG Simple Febrile Seizure 11 Diagnostic evaluation: History: Include characteristics of the seizure, duration, focality, recent immunizations, and if immunization status is current, family history of seizure, developmental delay, loss of consciousness. Physical Exam: General physical exam and neurological exam, status of fontanelle (age dependent), muscle tone and or strength. Diagnostics: Only to diagnose the cause of the fever Neurodiagnostic evaluation is not indicated in the routine evaluation of a simple febrile seizure aside from identifying the source of the fever.
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CPG Simple Febrile Seizure 12
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CPG Simple Febrile Seizure 13 Signs of a seizure: Loss of consciousness or arrest of behavior Abnormal eye movements: rolling up or deviated to one side Abnormal movements of the limbs: stiffening, rhythmic jerking, loss of tone Loss of bowel or bladder control Drooling, teeth clenching, tongue biting Abnormal respirations: temporary pause, grunting Source: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm
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CPG Simple Febrile Seizure 14
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CPG Simple Febrile Seizure 15 Simple Febrile Seizure- the American Academy of Pediatrics Clinical Practice Guideline for the Neurodiagnostic Evaluation of the Child (Duffner et al. 2014) states that management of the simple febrile seizures should be pointed at identifying and treating the source of the fever. Lumbar puncture (LP) is indicated in children with Signs and symptoms of central nervous system infections, who would be off guideline. LP is an option in children 6-12 months of age who is deficient in Hib and s pneumoniae immunization whom immunization status is unknown
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CPG Simple Febrile Seizure 16
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CPG Simple Febrile Seizure 17 Discharge Criteria: 1. The patient is back to baseline with a non-focal neurological examination 2. The likely source of the fever has been identified and treated 3. A treatment plan with appropriate follow up has been devised
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CPG Simple Febrile Seizure Note the NOT RECOMMENDED section 18
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CPG Complex Febrile Seizure 19
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CPG Complex Febrile Seizure 20
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CPG Complex Febrile Seizure 21
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Abortive Seizure Medications Rectal Diazepam – Dose 0.2-0.5 mg/kg, max 20mg (see next slide) Intravenous Diazepam – Dose 0.1-0.3 mg/kg, max 10mg Intranasal Midazolam – Dose 0.2 mg/kg, max 10mg Intramuscular Midazolam – Dose 0.2 mg/kg, max 6 mg Intramuscular Lorazepam – Dose 0.1mg/kg, max 4mg Intravenous Lorazepam – Dose 0.1mg/kg, max 4mg 22
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Abortive Seizure Medications 23
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CPG Complex Febrile Seizure 24
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CPG Complex Febrile Seizure 25
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CPG Complex Febrile Seizure 26 Non-urgent outpatient follow-up is recommended for complex febrile seizure No consensus was reached for phone consult.
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CPG Complex Febrile Seizure 27
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CPG Complex Febrile Seizure 28 Consider hospital admission when: The patient’s clinical status is unstable OR The infection causing the fever requires hospitalization for treatment OR Significant parental anxiety OR The home situation is unclear OR Transportation home or back to the hospital, if needed, is not reliable
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CPG Complex Febrile Seizure 29 Emergency department/Urgent Care discharge criteria Cause of the fever can be treated as an outpatient Patient has returned to neurological baseline Follow up plan is created; parents are educated on plan Parents are comfortable with the treatment and care plan Transportation home or back to the hospital, if needed, is reliable
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CPG Complex Febrile Seizure 30 DON'T FORGET
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Seizure First Aid Place child on side and protect them from injury. Make note of the time. Make note of all movements. Do not give any medications by mouth. Call 911 if seizure is lasting 5-10 minutes. Record event if able. 31
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Anticipatory guidance 32 Will my child have another seizure? Only 20-25% of typically developing, otherwise healthy children will experience recurrence of seizures. This means 75% or more will not have any further seizure activity Could my child die if it happens again? Death after a first recurrence of a simple febrile seizure has never been reported. Does brain damage occur? Brief seizures do not cause brain damage. https://patiented.solutions.aap.org/handout.aspx?resultClick=24&gbosid=156447
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Precautions for Families 33 What special precautions should we take with our child? Children should not be left unattended in any amount of standing water . Showers are okay as long as an adult is aware the child is in the shower and the door is not locked. A trusted adult should directly supervise the child in swimming pools, not just the lifeguard. Children may participate in athletics as long as they wear a helmet when appropriate for a given sport, as would any other child. Children should wear a helmet when operating any wheeled devices (tricycle, bicycle, scooter, roller skates, etc). Children should be supervised at heights (monkey bars, etc). Older children/adolescents should not cook over an open flame/stovetop for risk of injury. Microwave use is okay. Adolescents of driving age may not operate a vehicle for 6 months after a seizure as per Kansas and Missouri law. These laws vary by state. Adolescents may resume driving after achieving 6 months of seizure freedom.
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Clinical Practice Guidelines 34 Available at Childrensmercy.org Click on link in top right corner for HEALTHCARE PROFESSIONALS On right side of the screen, there is a link to EVIDENCE BASED PRACTICE
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References Nathan W. Mick, Rosen's Emergency Medicine: Concepts and Clinical Practice, Chapter 166, 2058-2068.e2 Bassel W. Abou-Khalil, Martin J. Gallagher, Robert L. Macdonald Bradley's Neurology in Clinical Practice, 101, 1563-1614.e13 Mohamad A. Mikati, Abeer J. Hani, Nelson Textbook of Pediatrics, Chapter 593, 2823-2857.e1 CMH Febrile Seizure Care Card American Academy of Pediatrics. Subcommittee on Febrile Seizures. Febrile seizures: guideline for the neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011; 127( 2): 389– 394; doi: 10.1542/peds.2010-3318 American Academy of Pediatrics. Subcommittee on Febrile Seizures. Febrile Seizures: Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures. Pediatrics. 2008; 121 (6): 1281-1286 35
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Questions?? THANK YOU!! 36