Question of the Week

Question

Question :

Posted On : 04 Oct 2025

I am seeing a lot of children between 3 and 9 years of age this season who have a history of fever for 4-5 days, then they developed one or two episodes of generalised convulsion followed by loss of consciousness for a few hrs. After treatment with anti epileptic medicine, they become conscious without any neurological deficit fever subsides after a few days of treatment. What could be the D/D should they need a long-term AED in cases of encephalitis to become conscious so early? There are no meningial signs.

Expert Answer :

Answer Discussion :

H

Hanan Omer

1

Encephalitis and no need for AED for long term mangment

4 Days ago

H

hizbullah khan

1

If previous history of fits/seizure with current such history better to get EEG to look for any background epileptiform activity.
If there, better to continue AEDs for at least 6 months with a tapering dose in subsequent months..

5 Days ago

D

Dfsa Ata

0

post viral MIs-c and other inflmmatory or immune mediated conditions

6 Days ago

S

ShubhraDaniel Sarkar

2

Complex Febrile Seizures or Influenza/viral infection–associated benign convulsions.

No their usually do not require long-term AEDs, unless:

Recurrent afebrile seizures later on.

Abnormal EEG with epileptiform activity.

Structural brain lesion or developmental delay.

Short-term benzodiazepine or phenytoin/levetiracetam use for acute control is fine, but AED should be tapered off after the acute phase once workup excludes epilepsy.

6 Days ago

A

Ahmed Hadi

0

viral encephalitis
no need for long term antiepileptic drugs

6 Days ago

Answer 1

They should not need long-term AED as obviously the seizures are provoked by fever and/or a neurotropic infection e.g., HSV6. You are right, an encephalitis should be more prolonged. Post-ictal sleepiness is sometimes profound after a long generalized seizure, but still not the same as loss of consciousness.

Question of the Week

Home

Partner Sites