This post mainly consist differential diagnosis and how it can differentiate
pic.1 cafe au lait patches,(black arrows) neurofibroma (white)
Meningitis / Encephalitis
- Fever,
- Drowsines,
- Irritabilit,
- Photo phobi,
- History of upper respiratory track infection or Ear discharge
- Purpuric skin rashers (Neisseria meningitidis)
- Neck stiffness
- Skin infection (Staphylococcus aureus)
Tuberculous Meningitis
- Contact history of Tuberculosis
- BCG scar
- Mantoux test
Cerebral malaria
- Travel to malaria endemic erea
- Fever with chills and rigours
Febrile convulsions
A febrile convulsion is a seizure that occur between the age of 3 months to 6 years with fever that is not result of central nervous system infection or any metabolic imbalance, and that occur in the absence of a history of prior afebrile seizures.
- Benign
- Occur with fever
- Age 6 month to 5 years
- Less postictal drowsiness
- Usually less than 15 min ( if more than it, It is a complex febrile convulsions.)
Difference of simple and complex febrile convulsions
Simple febrile convulsion
- Less than 15 minutes (few seconds)
- Primary generalized
- Usually tonic clonic
- Not recurrent within a 24 hour period
- Chance of developing subsequent epilepsy is not increased. Same as all children (1- 2%).
Complex febrile convulsion
- Continue more than 15 minutes,
- Focal,
- Recurs within 24 hours,
- Chance of developing subsequent epilepsy is increased. (4- 12%)
Epilepsy
- Long postictal drowsiness
- Past history of convulsions
- Antyepileptic drug withdrawal
- Neurocutaneous markers on skin
Metabolic causes
- Hypoglycemia
- fasting, associated with sweating
- Hyponatraemia
- vomiting, diarrhea
