Febrile seizures - 2019

Febrile seizures are a serious condition of children from 6 months to 5 years old. The occurrence of their uncomplicated form is more common. Other serious illnesses such as meningitis or epilepsy must be excluded in differential diagnosis. The diagnostic procedure contained in this algorithm serves to this purpose. Our algorithm emphasizes the correct diagnotics of the cause of the fever, the determination of the basic course of treatment in the acute phase and an adequate pharmacotherapy.

Published at: 21.5.2019


Kateřina Fabichová, MD
Chief Physician of the Perinatological centre, Hospital Most, Most, Czech Republic

This interactive algorithm takes student fully into the real situation. Convulsions in children are one of the most common diagnoses which can be seen in prehospital care and also in children hospital wards. Prolonged convulsions with loss of consciousness belong to one of the most stressful events for all personnel involved. This algorithm is focused on basic stabilisation of a child until ambulance arrives, rational use of adequate dose of anticonvulsive agent and quick use of ABCDE approach in postictal and pharmacological sedation. Differential diagnosis of seizure condition is vital – metabolic causes, neuroinfection, intracranial processes that could lead to intracranial hypertension and also fever induced seizures especially in children with positive family history. In algorithm you can also find later counselling process after prolonged seizures, including preventive management for relapse paroxysms. In each point of decision making the student has a chance to learn from his inaccurate answer and then choose again, which cannot be accomplished in real life.


LÍČENÍK, Radim, K. NEŠŤÁKOVÁ, T. KRCHŇÁKOVÁ, J. STROJIL, J. KILIAN a V. MIHÁL. Febrile Seizures – Guidelines for Examination of a Child with Simple Febrile Seizures, Adapted from the Guidelines of the American Academy of Pediatrics. Česká a slovenská neurologie a neurochirurgie [online]. 2017, 80/113(2), 228-231 [cit. 2018-12-18]. DOI: 10.14735/amcsnn2017228. ISSN 12107859.
Available at: http://www.csnn.eu/en/czech-slovak-neurology-article/febrile-seizures-guidelines-for-examination-of-a-child-with-simple-febrile-seizures-adapted-from-the-guidelines-60570

PIÑA-GARZA, J. Eric. Fenichel's clinical pediatric neurology: a signs and symptoms approach. 7th ed. London: Saunders Elsevier, 2013. ISBN 978-1-4557-2376-8.

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