BCH Pediatric Emergency Medicine Case Curriculum

Introduction
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Welcome to the BCH Pediatric Emergency Medicine Case Curriculum. This curriculum will introduce you to common pediatric cases seen in the PED and help you consider the evidence-based principles supporting the evaluation and management of a spectrum of pediatric illness.The module progresses through a case presentation. There is no time limit, though each case will likely take approximately 15 minutes to run through. If this is your first time, please review the commands and navigation of these cases demonstrated below.

Prior to evaluating this infant, consider the various etiologies of seizures in infants. Click below for a list of the more commonly referenced:

HISTORY

HPI: 17 month old baby is brought in by her mother for what is thought to be a seizure. The baby has been crying a bit today and his PO intake was decreased. Mom was holding the baby as she felt him turning stiff and then limp. His eyes rolled up into his head and arched his head back. She did not see any limb shaking and there was no tongue biting (yet the baby just started teething last month). Mom called 911 and an ambulance arrived within 12 minutes. By that time the baby started to response but was sleepy and clingy and his temperature was 100.9F.

Additional history

Imm: UTD 15 months, no recent imm.
Allergies: None
PMH: Full term with no complications around a vaginal delivery. No ongoing medical problems
Meds: None

Common Infant Seizure Etiologies

Febrile seizures (simple and complex)
Epilepsy
Structural lesions: Tumors, cysts, malformation syndromes
Infectious: acute bacterial meningitis meningoencephalitis, shigella gastroenteritis
Electrolyte abnormalities
Toxin mediated
Trauma

Based on the brief history, this sounds like it may be a febrile seizure. Consider what features on history might suggest an etiology other than febrile seizures.

Click to review suggestions.