儿科见习热惊.pdf

Febrile Seizures (Febrile convulsions) Department of Pediatrics The Second Affiliated Hospital of Shantou University Medical College General consideration ❖ 1. Definition: A febrile convulsions is a associated with fever in the absence of another cause and not due to intracranial infection. General consideration ❖ 2. Occur in about 3 ％of children. ❖ 3. Usually between 6 months and 3 years, but up to 6 years of age. ❖ 4. G ic predisposition. Clinical features ❖ The seizure usually occurs early in a viral infection when the temperature is rising rapidly. Clinical features ❖ The seizures are usually brief, lasting 1～ 2min, and are generalised tonic or tonic- clonic. Seizures recur ❖ 1. In about 15％of case, seizures recur in the same illness. The overall risk of a further febrile convulsion is 1 in 3, and of these a further third will have three or more seizures. ❖ 2. The recurrence risk is higher if the onset occurs before of 1 year and if there is positive family history. Prognosis ❖ Febrile convulsions usually have a benign prognosis; only about 1％of children with febrile convulsions subsequently develop epilepsy. Risk factors ❖ Risk factors for the subsequent development of localisation-related (partial) epilepsy are : 1. A prolonged seizure (longer than 30 min). 2. If the seizure is focal. 3. If seizures recur within the same illness. 4. Complex febrile seizures. Differential Diagnosis Simple FS Complex FS Age 6m～6y ＜6m or ＞6 y Prolong ＜15 min ＞1 5