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Management of the Sick Child
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Antipyretics can be prescribed for the child’s comfort. There is no physiological need to bring the temperature down unless the child is distressed. It does not reduce the risk of febrile seizures. Paracetamol (15 mg/kg per dose every 6 hours) and ibuprofen (10 mg/kg per dose every 8 hours) can be prescribed, with careful parental guidance to avoid risk of overdose or incorrect usage. Care must be taken in children with SAM. Only use antipyretics when necessary, and only prescribe one dose at a time. Ibuprofen should not be used in Phase 1 of SAM treatment.
Paediatrics
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
About three in 100 children aged six months to six years will convulse during an illness with a raised body temperature. Some children have multiple febrile seizures. Certain infecting organisms are more commonly associated with the problem, there is a genetic component, and the rate of temperature change is probably a factor. In general, febrile seizures are benign and of little consequence (except in scaring parents who witness them). It is common in less busy hospitals to admit overnight a child with their first febrile seizure but not subsequently.
Influenza neurologic complications
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Larry E. Davis, Jennifer R. Plourde
Febrile seizures, a common cause of childhood seizures, are defined as a seizures in children aged 6 months to 5 years associated with fever but without evidence of intracranial infection or other definable cause [98]. Patients with a febrile seizure should not have abnormalities on their EEG or neuroimaging and at discharge should be normal.
No association between enterovirus 71 (EV71) vaccination and risk of febrile seizures: a population-based near real-time surveillance study
Published in Expert Review of Vaccines, 2022
Yixin Sun, Liang Zhang, Ning Li, Houyu Zhao, Rui Ma, Ting Fang, Tianchi Yang, Guozhang Xu, Zhike Liu, Siyan Zhan
Febrile seizures are the most common neurologic disorder in childhood, affecting up to 5% of children under 5 years of age [34]. This study estimated a background incidence of 6.11 (95% CI: 5.90 to 6.33) per 1000 person-years in Chinese children aged 6–71 months, and the peak incidence occurred in the second year of life, which was in line with the previous literature [35,36]. The causes of FS are multifactorial with both genetic and environmental factors. Routine childhood immunizations such as measles-containing vaccines and influenza vaccines have been associated with a transient increase risk of FS during the periods of peak inflammatory response (i.e. 7–14 days for live attenuated vaccines and within 72 hours for inactivated vaccines) [28,37,38]. But the mechanism of vaccination-related seizures remains unclear. One hypothesis is that vaccination sometimes induces febrile reaction, elevated brain temperature could affect neuronal functions and cytokine and thereby trigger a seizure [39]. However, recent studies indicate that predisposing factors in the child such as genetic or structural defects may be the underlying cause of vaccination-related onset of seizure and subsequent neurologic deterioration [40]. Thus, assessing the causal link between vaccines and seizure requires great caution.
Acetaminophen and ibuprofen in the treatment of pediatric fever: a narrative review
Published in Current Medical Research and Opinion, 2021
In the remaining 2 studies, results were mixed. In a randomized, double-blind, crossover study in children aged 10 months to 4 years with febrile seizures, Van Esch et al.30 found that ibuprofen reduced rectal temperatures more than acetaminophen at the primary endpoint of 4 h (p = .05; p = .04 after adjusting for covariates). Finally, in the study by Walson and colleagues27 detailed above, OTC dose comparisons were also studied. Ibuprofen 10 mg/kg was associated with a significantly greater percent temperature reduction at 0–6 h (p < .05) versus ibuprofen 2.5 mg/kg and ibuprofen 5 mg/kg. Acetaminophen 15 mg/kg was associated with significantly greater fever reduction versus ibuprofen 2.5 mg from hours 0‒6 and versus ibuprofen 5 mg/kg during the 0- to 12- and 0- to 24-h intervals (p < .05 for each) but not over the interval of 0‒48 h versus ibuprofen 5 mg/kg.
Safety considerations selecting antiseizure medications for the treatment of individuals with Dravet syndrome
Published in Expert Opinion on Drug Safety, 2021
Rima Nabbout, N Chemaly, C Chiron, M. Kuchenbuch
Dravet syndrome is the archetypical genetic rare epilepsy. Seizures occur in a previously healthy infant and can be misdiagnosed after the first event with febrile seizures. Seizures quickly invade the everyday life of the child and the family, as unpredictable and prolonged events often evolving to status epilepticus occur during infancy and early childhood. To limit adverse events and to improve long-term outcome, practitioners must have a knowledge of DS to establish early diagnosis and to shape their treatment strategy between indicated and contra-indicated medicines. Indeed, practitioners have to consider market authorization, known adverse events, galenic form, and drug–drug interactions to best fit their prescription to patient’s characteristics and to evaluate the best benefit risk. In general, except in urgent situations, introduction of ASM must be very progressive with a short- and long-term evaluation of efficacy and safety of each ASM.