Febrile Seizures

Mentor: dr. Pulung M. Silalahi, Sp. A

Written by: Hafiz Fadhli (1102009126)

Department of Pediatric
Rumah Sakit Tk.1 Bhayangkara Raden Said Sukanto
Faculty of Medicine Yarsi University
Periode 25th of May 2nd of August 2015

Definition
A febrile seizure is a seizure accompanied by fever
(temperature 38oC) without central nervous
system infection, that occurs in infants and
children 6 through 60 months of age.
(American Academy of Pediatrics)

Epidemiology

Febrile seizures occur in 2 5% of all children and

as such, make up the most common convulsive
event in children younger than 60 months

Etiology
Genetic
Predispotitio
n

Infectious
Cause

Vaccines

Risk Factor

Fever

Age

Genetic

Malnutrition

Patophysiology
Fever
(increasing 1oC)
Basal metabolism

(10 15%)

Increasing O2 capacity
+ 20%

Balance changing
(cell neuron membran)
Difuse into membrane
(ion K+ ------- ion Na+)
Released electric charge
neurotransmitter

Seizure

Glucose metabolism
Seizure
Changed as energy
Balancing cell
Na K
ATP-ase
(balancing
differential
potential)

Membrane potential

Released electric
charge
Differential potential

Classification

Livingston criteria:

Simple Febrile Seizure

Epilepsy which caused by fever

IDAI:

Simple Febrile Seizure

Complex Febrile Seizure

Diagnosis

Anamnesis

Seizure

Frequency and duration

When

First time or second time

If it has, when did it happens?

Type of seizure

Another symptoms (vomit, paralyze, decreasing of

cognitive function)

Consciousness

Neurological Deficit

Historical of pregnancy

Family history

Historical disease

Historical of growth

Physical Examination

TTV

Growth development status

Neurological examination

Fracture examination

Supporting Examination

Laboratory

Lumbal Puncture

EEG

CT-scan

MRI

Differential Diagnosis

Intracranial Infection

Toxic

Metabolic Disorder

Commusio/contusio

Historical of stopping anti-epilepsy medication

Therapy

Breathing management

Relaps prevention

Medication

Education

Medication

Antipiretic

Paracetamol

Ibuprofen

Antikonvulsant

Diazepam

Lorazepam

Fenitoin

Fenobarbital or valproic acid

Parents Education

Make sure that febrile seizure has a good

prognosis

Tell them how to take care of febrile seizure

Give them information about relapsing

possibilities

Tell them to give medication for prevention but

also they must take a good care about its side
effect

If its relapsing

Tell them to keep calm and dont panic

Untied every clothes and accessories especially

in necks area

If the child unconsciousness, put the child in

supine and clean up the mess if it is there

Do not put anything on mouth

Observation the temperature

Memo the type of seizure

Memo how long does it takes

Stay with the child during seizure

Give diazepam rectal, do not ever gave it when

the seizure has stopped

Bring the child to doctor or to the hospital for

next therapy if the seizure takes more than 5
minutes or stopped

Hospital Indication

> 1 period of seizure in 24 hours

Hiperpireksia

Complex seizure

There is neurological deficit

Prognosis

Quo ad vitam

: bonam

Quo ad functionam

: bonam

Quo ad sanactionam

: bonam

THANK YOU