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Febrile seizure 2011 熱性けいれん
単純性か複雑性かをちゃんと鑑別するのが大事っすね！
■診断：http://pediatrics.aappublications.org/cgi/reprint/127/2/389
1.febrile seizure
seizure accompanied by fever (temperature100.4F or 38C by any method),
without central nervous system infection,
occurs in infants and children 6 through 60 months(5yo) of age.
Febrile seizures occur in 2% to 5% of all children
make up the most common convulsive event in children younger than 60 months
2. simple febrile seizures (classically a generalized tonic-clonic seizure)
lasted for less than 15 minutes
did NOT recur within 24 hours.
=> no evidence of increased mortality, hemiplegia, or mental retardation.
3.complex febrile seizures
focal, prolonged (15 minutes), and/or recurrent within 24 hours.
1.In any infant between 6 and 12 months of age who presents with a seizure and fever, a lumbar puncture
is an option when the child is considered deficient in Haemophilus influenzae type b (Hib) or
Streptococcus pneumoniae immunizations (ie, has not received scheduled immunizations as recommended) or
when immunization status cannot be determined because of an increased risk of bacterial meningitis.
*approximately 25% of young children with meningitis have seizures as the presenting
sign of the disease, some are either
＜非推奨＞
1.The following tests should not be performed routinely for the sole purpose
of identifying the cause of a simple febrile seizure:
2.measurement of serum electrolytes, calcium, phosphorus,
magnesium, or blood glucose or complete blood cell count.
3.EEG should not be performed in the evaluation of a neurologically healthy
child with a simple febrile
4.Neuroimaging should not be performed in the routine evaluation of
the child with a simple febril seizure.
■長期マネージメント：http://aappolicy.aappublications.org/cgi/reprint/pediatrics;121/6/1281.pdf
＜予防的に毎日服用＞
1.Phenobarbital
副作用：hyperactivity,irritability, lethargy, sleep disturbances, and hypersensitivity reactions
2.Primidone（15 to 20 mg/kg/d)
3.Valproic Acid
副作用：fatal hepatotoxicity (especially in children younger than 2 years),
thrombocytopenia, weight loss/gain, gastrointestinal disturbances,pancreatitis.
Carbamazepine, Phenytoin
Σヽ(｀д´；)ﾉ うおおおお！
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