Monday, February 27, 2012

Febrile seizure

Saw a 5 y/o child with seizure that lasted for 15 minutes. Temperature was 38.8 degrees.

Dx: Febrile seizure secondary to some URTI (apparently the child has prominent adenoids... he has been snoring throughout the entire consultation)

I asked if he had any rash but the parent said no.

Areas I need to improve on:
  •  I guess I could have asked more symptoms to rule out meningitis (e.g. photophobia, neck stiffness) if the patient was able to give a response or test it on the patient (e.g. kernig's / brudzinski's sign). 
  • I should also have asked more about the seizure itself: During - irregular breathing? pallor? After - is he back to his usual self?

Learning point:
  • Parent getting reassurance from the doctor in that simple ones do not cause permanent brain injury and most children usually grow out of it by their 6th birthday.

On a side note, family history is also important. I remember clarking a patient before whose entire family had some form of febrile seizure.....

Anyways I think I have improved on my history taking skills... practice practice practice (unlike Allen Iverson :P)

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