Resumo
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- doença febril
- convulsão
Other diagnostic factors
- exame pós-ictal normal
Risk factors
- elevação da temperatura
- idade jovem
- sexo masculino
- história familiar de convulsões febris
- infecção bacteriana ou viral fora do sistema nervoso central
- vacinações
- exposição pré-natal à nicotina
- deficiência de ferro
- complicações na gestação, no trabalho de parto e no parto
Diagnostic tests
1st tests to order
- o diagnóstico é clínico
Tests to consider
- punção lombar
- estudos virais
- hemocultura
- eletroencefalograma (EEG)
- ressonância nuclear magnética (RNM) cranioencefálica
- sódio sérico
- Hemograma completo
- glicemia sanguínea capilar
- glicose sérica
- perfil de ferro
Treatment algorithm
estado de mal epiléptico febril
primeira convulsão febril simples
primeira convulsão complexa
enfermidade febril com história prévia de convulsão simples ou 1 convulsão complexa
história de 2 ou mais convulsões febris complexas com ineficácia do tratamento com diazepam
Contributors
Authors
Damian Roland, BMedSci, MBBS, FRCPCH, PhD
Honorary Associate Professor and Consultant in Paediatric Emergency Medicine
Paediatric Emergency Medicine Leicester Academic (PEMLA) Group
Children’s Emergency Department
Leicester Royal Infirmary
Leicester
UK
Divulgaciones
DR declares that he is a previous member of the National Institute for Health and Care Excellence Feverish Illness in Children Guideline Group.
Agradecimientos
Dr Damian Roland would like to gratefully acknowledge Dr Leena Mewasingh, Dr Frances Morrison, Dr John J. Millichap and Dr J. Gordon Millichap, previous contributors to this topic. LM has received funding from drug companies (e.g., Eisai) to attend medical conferences and been invited to an educational symposium (Novartis, LivaNova). FM declares that she has no competing interests. JJM serves as an Associate Editor of Neurology and serves on the editorial board of Pediatric Neurology Briefs; volunteers on the medical advisory board of The Jack Pribaz Foundation (KCNQ2.org); received speaker honoraria from Invitae; received royalties for online monographs from Up-To-Date; served on the scientific advisory board for Mallinckrodt; is principal investigator for a clinical trial funded by UCB Pharma; and is the principal investigator for research grants from Citizens United for Research in Epilepsy and the Thrasher Research Fund. JJM is an author of a number of references cited in this topic. JGM is an author of a number of references cited in this topic.
Revisores por pares
Robert S. Rust, Jr., MA, MD
Professor
Department of Neurology
University of Virginia Health System
Charlottesville
VA
Divulgaciones
RSR declares that he has no competing interests.
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
American Academy of Pediatrics: Subcommittee on Febrile Seizures. Clinical practice guideline: neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011 Feb;127(2):389-94.Texto completo Resumen
American Academy of Pediatrics. Febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics. 2008 Jun;121(6):1281-6.Texto completo Resumen
Natsume J, Hamano SI, Iyoda K, et al. New guidelines for management of febrile seizures in Japan. Brain Dev. 2017 Jan;39(1):2-9. Resumen
Offringa M, Newton R, Nevitt SJ, et al. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2021 Jun 16;(6):CD003031.Texto completo Resumen
Wilmshurst JM, Gaillard WD, Vinayan KP, et al. Summary of recommendations for the management of infantile seizures: task force report for the ILAE Commission of Pediatrics. Epilepsia. 2015 Aug;56(8):1185-97.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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