MAGEZI

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FEBRILE CONVULSIONS

Posted by SAMUEL ISABIRYE on February 18, 2013 at 8:10 AM

A disorder mainly affecting children between 6 months and 6 years characterised by generalized tonic-clonic seizures in a febrile illness

Cause 

Malaria fever

Respiratory tract infections

Urinary tract infections

Other febrile conditions

Clinical features

Elevated temperatures (>38°C)

Convulsion is usually brief (<15 minutes) but may recur if temperature remains high

No CNS infection or neurological abnormality in the period between convulsions

Differential diagnosis

Epilepsy

Meningitis

Encephalitis

Brain lesions

Trauma

Hypoglycaemia

Hypocalcaemia

Investigations

Blood: slide for malaria parasites; haemogram LP and CSF examination

Full blood count

Random blood glucose

Urinalysis , culture and sensitivity

Chest xray

Management HC2

Treat the cause

Lie prone

Use tepid sponging to help lower the temperature

Give an antipyretic:

paracetamol 10mg/kg every 8 hours prn

Give diazepam 500 micrograms/kg rectally

- maximum dose: 10mg

- repeat prn after 10 minutes

-if diazepam rectal dose-form is not available use diazepam injection solution and give the same dose rectally using the syringe after

removing the needle

 

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