MBBS viva · Paediatrics
Febrile seizures — viva (simple vs complex, LP, counselling)
Viva on febrile seizures: definition, simple vs complex, acute benzos, LP indications, no routine prophylaxis, recurrence counselling.
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"An 18-month-old had a 3-minute generalised seizure with fever. Discuss."
Q1: Definition and classification (2 min)
- 6 months–5 years, fever, no CNS infection/prior afebrile seizure.
- Simple: generalised, <15 min, once in 24 h.
- Complex: focal, ≥15 min, or multiple in 24 h; status >30 min.
Q2: Acute care and work-up (3 min)
- If ≥5 min: lorazepam 0.1 mg/kg IV / midazolam 0.5 mg/kg buccal / diazepam 0.5 mg/kg PR; glucose check.
- LP if <12 months or any meningism/complex/ill child.[1]
- No routine EEG/CT after simple febrile seizure.
- Find and treat fever source.
Q3: Prognosis and prophylaxis (2 min)
- Recurrence ~30%; epilepsy 2–5% after simple.
- No continuous AED for simple febrile seizures.
- Antipyretics for comfort, not reliable prevention.
- Rescue meds/education for selected families.
Q4: Red flags (1 min)
- Age <6 months or >5 years, focal persistent deficit, neurocutaneous signs, developmental regression, afebrile seizures → not “simple febrile seizure pathway.”
Key phrases
- "Simple does not equal epilepsy."
- "Benzodiazepine if still seizing at five minutes."
- "No routine prophylaxis after simple febrile seizure."
References1ShowHide
- [1]AAP Subcommittee on Febrile Seizures. Neurodiagnostic evaluation of simple febrile seizure. Pediatrics, 2011.PMID 21285335