Referat

“Fever Seizure Examination”

EMIRIZAL A SURYA
1865050029
Supervised by: dr. Alfred Sp.A

KEPANITERAAN KLINIK ILMU KESEHATAN ANAK

FAKULTAS KEDOKTERAN UNIVERSITAS KRISTEN
INDONESIA
PERIODE 25 FEBRUARI 2019 -
JAKARTA
2019 1
 DEFINITION
Febrile seizures are seizures that occur in an increase in
body temperature (rectal temperature above 38°C)
without infection with the central nervous system,
electrolyte or other metabolic disorders
Consensus Statement on Febrile Seizures

Occurs between the ages of 6 months to 5 years

Seizures in febrile seizures are associated with fever but

no evidence of intracranial infection or other causes
 PATHOPHYSIOLOGY
• Fever (General clonic seizures / clonic tonics)
• Paroxysmal depolarization shift (PDS) 
Remove excessive electrical charge on brain
neurons & stimulate other neuron cells to
release electrical charges  together
hyperexitability of brain neurons.
• PDS is caused by the ability of cell membranes
to release excessive electrical charge, reduced
inhibition by GABA neurotransmitters
 CLASSIFICATION
Simple Fever Seizures Complex Fever Seizures
Less than 15 minutes More than 15 minutes
General tonic or clonic without focal One-sided focal / partial seizures
movements Or
General seizures are preceded by partial
seizures
Not repeated within 24 hours Repeated / more then 1 time in 24 hours
 ANAMNESIS
• History of seizures, type of seizures,
consciousness and duration of seizures
• Temperature before / during seizures,
frequency within 24 hours
• Symptoms of ARI, UTI, OMA
• Family history
Algorithm for Diagnosing Seizures in
Children
Seizures

(+) fever (-)

neurological disorders Epilepsy

Metabolic disorders
(+) (-)
Encephalitis Febrile seizures
Meningitis
Brain abscess
 PHYSICAL EXAMINATION
• Vital sign
• Sign of acute head trauma
• Generalist status
 Physical examination in children with
febrile seizures
Examination Things You Need to Assess
Awareness Is there a decrease in consciousness
Temperature Is there a fever
Signs of meningeal stimulation Stiff neck, Brudzinsli I and II, Laseque
Examination of the cranial nerves Are there neurological deficits
Sign of increased intracranial pressure The large fontanel (UUB) protrudes, papillary
edema

Sign of infection outside the CNS ARI, OMA, UTI

 Supporting investigation
• Laboratory examination
• Radiological examination
• Cerebrospinal fluid examination
• Electroencephalography examination
Thank You

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