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b. At Emergency:
G. INVESTIGATIONS: Routinely not necessary i. Reassurance to the parents
a. Lab: ii. ABC
i. Blood: CBC, Culture iii. Antipyretic:
ii. Urine: R/E , Microscopy, Culture 1. Acetaminophen, 10-15 mg/kg PO/PR q4-
iii. Electrolyte assessment 6h
2. Ibuprofen, 200-400 mg PO q4-6h while
b. Imaging: symptoms persist
i. CXR: Rule out LRTI 3. Aspirin to be avoided as it can cause
ii. CT: If >4 episodes or clinically indicated Reye’s Syndrome
iv. Anticonvulsants:
c. Other: 1. Diazepam
i. EEG: a. 2-5 years: 0.5 mg/kg PR
1. Indi: b. 6-11 years: 0.3 mg/kg
a. Atypical febrile convulsion c. May repeat rectal dose once after 4-
b. F/H/O Epilepsy 12 h if needed
2. After 6 weeks of 1st attack 2. Midazolam, 0.2 mg/kg IV
3. Normal in Simple seizure v. Antibiotics: If infec present
vi. If seizure not controlled, RX in the line of
status epilepticus
I. COMPLICATIONS:
a. Recurrence:
i. Risk factors:
1. Young age at time of first febrile seizure
2. Female
3. Relatively low fever at time of first
seizure
4. Family history of a febrile seizure in a
first-degree relative
5. Brief duration between fever onset and
initial seizure
6. Multiple initial febrile seizures during
same episode
ii. Prophyllaxis:
1. General measures:
a. Temperature control during fever
with tepid sponging
b. Use of antipyretics
2. Specific:
a. Oral Diazepam or Midazolam before
the spike of fever (Intermitternt)
b. If Atypical seizure or F/H/O Seizure
(Continuous)
i. Sod valproate, 10-20 mg/kg/day
ii. Phenobarbitone, 3-5 mg/kg/day
iii. For 1-2 yrs or age of 5 yrs,
whichever comes earlier
3. Vaccine: Influenzae
J. PARENT COUNSELLING:
a. Steps to be taken in case child has another
seizure
b. Call for assistance if the seizure lasts longer
than 10 minutes or if the postictal period lasts
longer than 30 minutes
c. Benign nature of febrile seizures
d. Reassured that simple febrile seizure does not
lead to neurologic problems or developmental
delay