Veja grátis o arquivo Convulsão febril enviado para a disciplina de Neuro Infantil Categoria: Anotações – Veja grátis o arquivo Convulsão febril enviado para a disciplina de Neuro Infantil Categoria: Anotações – 4 – GUERREIRO, Marilisa M. et al. Profilaxia intermitente na convulsão febril com diazepam via oral. Arq. Neuro-Psiquiatr. [online]. , vol, n.2, pp
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BMJ Best Practice
Unauthorized reproduction of this article is prohibited. In a case- control study that compared children convulwao a first febrile seizure, febrile status epilepticus was associated with younger age, lower body temperature, longer dura- febri, of unrecognized fever before febrile seizure, female sex, documented struc- tural temporal lobe abnormalities on a previous brain MRI, and a first-degree relative with febrile seizures.
When such risk factors exist alone or in combina- tion, it may be prudent to develop an acute seizure intervention at home, fol- lowed by initiating an emergency med- ical services call for early and effective treatment of potential febrile status epi- lepticus.
Delayed treatment and the de- velopment of febrile status epilepticus in a child is a risk factor for acute brain injury, the development of epilepsy, and long-term neurocognitive disability. However, one should keep in mind that a subset of children with prolonged febrile seizures or febrile status epilepticus could develop long- term neurologic consequences.
Prompt attention to diagnose the cause of the fever is es- sential. A few studies have reported ben- efit from intermittent benzodiazepines during fever for preventing febrile sei- zures and reducing emergency depart- ment visits and hospital admissions. A 2- to 3-day course of oral diazepam or clobazam was used successfully to pre- vent recurrences.
In addition, benzodiazepines can cause sedation, can interfere with hydra- tion and feeding, and may delay the recognition of a serious illness. Rectal diazepam is available in the United States as convlsao acute abortive treat- ment of an ongoing seizure and has been successfully used in febrile seizures.
Care- givers should be educated in the timing and technique of administering the med- ication as well as close monitoring after its use. Using febirl diazepam at home is an attractive option in the hands of savvy caregivers but may provide a false sense of security. Caregivers should be cau- tioned that if the convulsion continues after rectal diazepam total duration longer than 5 minutes or sensorium does not recover, emergency medical services should be immediately con- tacted for treatment of potential fe- brile status epilepticus.
A study concluded that once ffebril, febrile status epilepticus rarely stops sponta- neously, and it is fairly resistant to anti- epileptic medications. Earlier onset of effective treatment results in shorter total seizure duration.
In this study, even the subjects who received medication prior to emergency department arrival seized for a median of 81 minutes.
Therefore, it may be prudent to suggest administra- tion of rectal diazepam at the onset of KEY POINTS h The risk of developmental, behavioral, and academic disability in children with febrile seizures is no greater than in the general population. Phe- nobarbital and valproate are touted to successfully reduce the recurrence of febrile seizures; however, they may not reduce the ultimate risk of devel- oping epilepsy. Long-term treatmentwith daily anticonvulsants may be justifiable only in a small subset of children with complex febrile seizures and febrile status epilepticus with multiple risk factors that portend a high risk of epilepsy.
No guidelines exist for initiation of daily anticonvulsants in febrile seizures, and it remains a matter of clinical judgment. It donvulsao im- portant to recognize this condition and offer a customized evidence-based plan of care to each family. The majority of children can bemanaged by application of the essential clinical principles outlined in this article.
Guidelines for epidemiologic studies on epilepsy.
Epilepsia ; 34 4: Neurodiagnostic evaluation of the child with a simple febrile seizure. Febrile convulsions in a national cohort followed up from birth. IVprevalence and recurrence in the first five years of life. Epidemiology of febrile and afebrile convulsions in children in Japan.
Febrile seizures inasouth Indiandistrict: Dev Med Child Neurol ;39 6: Utility of lumbar puncture for first simple febrile seizure among children 6 to 18 months of age. Human herpesvirus 6 and 7 in febrile status epilepticus: The risk of seizure disorders among relatives of children with febrile convulsions. Generalized epilepsy with febrile seizures plus. A genetic disorder with heterogeneous clinical phenotypes.
Brain ; pt 3: IIVmedical history and intellectual ability at 5 years of age.