Febrile Convulsions

Two to four percent of children experience a convulsion associated with a febrile illness; 25—33% of these will have another febrile convulsion. Only 2—3% become epileptic in later years. Several factors are associated with an increased risk of developing epilepsy: preexisting neurological disorder or developmental delay, a family history of epilepsy, or a complicated febrile seizure (i.e., the febrile seizure lasted more than 15 minutes, was one-sided, or was followed by a second seizure in the same day). If all of these risk factors are present, the risk of developing epilepsy is ~10%. For children at high risk of developing recurrent febrile seizures and epilepsy, rectally administered diazepam at the onset of fever may prevent recurrent seizures and avoid side effects of chronic therapy. Uncertain efficacy and substantial side effects argue against the use of chronic phenobarbital therapy for prophylactic purposes in this condition.

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