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  #1  
Old 04-25-2016
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Default CNS question

A 2 year old child is brought to the ED by his mother after "he threw a fit" two days back. She could not bring the child in sooner due to the snowstorm. Mother states that it happened just the one time. She had noticed jerking movements involving the entire body which she reports lasted for around 3 minutes. The child was drowsy and confused after this happened. Now, the child is alert, awake and has no seizure activity. On a detailed history, mother admits that the child caught a 'stomach bug' from daycare and had a temperature of 103 deg F prior to the event. She is now concerned that her child may have epilepsy in the future. Which of the following best address the mothers concerns?
1. There is a slightly increased future risk of epilepsy compared to the general population
2. There is no future risk of epilepsy compared to the general population
3. There is a future risk of epilepsy and the child would have to be started on antiseizure medications as soon as possible
4. There is a decreased risk of future epilepsy compared to the general population
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  #2  
Old 04-25-2016
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2?
i am guessing not sure
simple febrile sizure?
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  #3  
Old 04-26-2016
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Quote:
Originally Posted by usmle1122 View Post
2?
i am guessing not sure
simple febrile sizure?
Nope not 2...
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  #4  
Old 04-26-2016
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Simple febrile seizure- choice 1
the risk that a child will develop epilepsy after a single, simple febrile seizure is slightly higher than that of a child who never has a febrile seizure.
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Old 04-26-2016
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[QUOTE=saxo; Which of the following best address the mothers concerns?
1. There is a slightly increased future risk of epilepsy compared to the general population
2. There is no future risk of epilepsy compared to the general population
3. There is a future risk of epilepsy and the child would have to be started on antiseizure medications as soon as possible
4. There is a decreased risk of future epilepsy compared to the general population[/QUOTE]

confused between A and C,
but i wil go with (A)
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  #6  
Old 04-26-2016
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Yep it 1. Posted it as MTB 3 gave it incorrectly.

Simple febrile seizure (generalized, less than 10-15 minutes, does not recur in 24 hour period, rapid onset fever more than 38 deg C, no Hx of epilepsy/CNS infection/systemic metabolic abnormality responsible for the seizure). Simple febrile seziure is associated with a slightly increased risk (1-2%) of epilepsy compared to the general population (Source: uptodate, MTB has same question which says no risk of epilepsy).

Complex febrile seizure (focal, prolonged or more than 15 minutes, recurs in 24 hour period) is associated with increased risk of future febrile seizures and future epilepsy (5-10%, similar to family hx of epilespy, abnormal developmental milestones)

Dx clinical, no tests required

Mx simple of complex febrile seizure lasting more than 5 minutes requires Rx with IV benzos (diazepam or lorazepam) or buccal midazolam
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Old 04-26-2016
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Quote:
Originally Posted by saxo View Post
A 2 year old child is brought to the ED by his mother after "he threw a fit" two days back. She could not bring the child in sooner due to the snowstorm. Mother states that it happened just the one time. She had noticed jerking movements involving the entire body which she reports lasted for around 3 minutes. The child was drowsy and confused after this happened. Now, the child is alert, awake and has no seizure activity. On a detailed history, mother admits that the child caught a 'stomach bug' from daycare and had a temperature of 103 deg F prior to the event. She is now concerned that her child may have epilepsy in the future. Which of the following best address the mothers concerns?
1. There is a slightly increased future risk of epilepsy compared to the general population
2. There is no future risk of epilepsy compared to the general population
3. There is a future risk of epilepsy and the child would have to be started on antiseizure medications as soon as possible
4. There is a decreased risk of future epilepsy compared to the general population
1. There is a slightly increased future risk of epilepsy compared to the general population

The child had a simple febrile seizure. There is a possibility of recurrence and a slight increase in risk of developing epilepsy, but it is important to stress the importance of letting the child lead a normal life.
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  #8  
Old 04-26-2016
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I agree with choice 1 as well
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