Diagnostic Dilemma

Atypical Febrile Seizure


Author: Pediatric Oncall
Question
A 7-month-old boy born of non-consanguineous marriage presented with 3 episodes of convulsions in one hour, fever and cough, cold for 1 day. The 1st convulsion was generalized tonic-clonic associated with uprolling of eyes and lasted for 3 minutes without postictal drowsiness, 2nd convulsion occurred after 10 minutes and was left-sided focal and responded to Inj Phenobarbital and midazolam. The third convulsion was also a left focal convulsion. Milestones, birth history is non-contributory. On examination, he was conscious, had normal vital parameters. Anterior fontanelle was open, level. Blood pressure was normal. There were no rickets, meningeal signs, or any focal neurological deficit. The treating physician diagnosed him as atypical febrile convulsion.

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