Febrile seizures are seizures that occur on a rise in body temperature (over 38 degrees Celsius) caused by the extra cranial process.
Febrile seizure is an event in infants or children who usually occurs between the ages of 3 months to 5 years was associated with a fever but never proven intracranial infection or a particular cause. (Consesnsus Statement On Febrile Siezures, 1980)
Originator or Risk Factors of Febrile Seizures
High fever caused by upper respiratory tract infection, pneumonia, gastroenteritis and urinary tract infections.
- History of febrile seizures in parents or siblings.
- Delayed development.
- Problems in the newborn period.
- Children in special care.
- Children with low levels of Na.
- Family history of epilepsy.
Pathophysiology of Febrile Seizures
In case of fever 1oC rise in temperature will lead to increase in basal metabolism 10-15% and 20% O2 requirements thus change the balance of the cell membranes of neurons and in a short time diffusion of sodium and potassium ions through the membrane before, with the result of loose cargo electricity. Remove the charge is so large that it can spread throughout the cell and surrounding cell membrane with the help of a material called "neurotransmitters" and there was a seizure.
Examination
1. Vital signs
- Decreased consciousness.
- Ictal period : Increased pulse, respiration, blood pressure and temperature.
- Postictal : normal V5 sometimes depression.
2. Physical examination
- Head: head shape disproportion, generalized seizures, tonic clonic and headaches.
- Eyes: Pupil dilatation, movement of the eyeball and eyelid fast, light reflexes down and red conjunctiva.
- Mouth: Excessive production of saliva, vomiting and Cyanosis oral mucosa.
- Nose: The existence nostril breathing, Cyanosis.
- Neck: In tetanus occurs stiff neck.
- Chest:
- Ictal period: Cyanosis, respiratory motion and decrease the pull intercostae.
- Postictal: Apnoe or breath deep and slow.
- Abdomen:
- Ictal period: Increased spingter blader and muscle tone.
- Postictal: muscle relaxation and hiperperistaltik.
- Extremity
- Ictal period: spasms in upper and lower extremities and cyanosis of the fingers and toes.
- Postictal: muscle relaxation and pain and weakness in the muscles.
3. General examination
- Electrolytes: Electrolyte imbalance predisposes to seizures.
- Glucose: Hypoglycemia predispose to seizures.
- BUN: Increased BUN is a potential seizure.
- CBC: Aplastic Anemia can occur as side effects of drug administration.
- LP: to detect the presence of abnormal pressure and signs of infection.
- Skull X-ray: the existence of space and lesions persisted.
- EEG: The focus of seizure activity.
- CT scan: Local cerebral abscess detect tumor lesions with or without contrast.
