Febrile convulsions are benign and occur in 3% of healthy children ages 6months to 6 years old and usually with a temperature of >38C. It’s often caused by a viral infection. Onset of convulsion may be sudden with no preceeding illness.

10-15% of children will have a repeated seizure. However, there’s no increase risk of mortality or development of epilepsy.

Parents must stay calm, don’t stick fingers in child’s mouth, place them on flat surface away from danger, don’t dip child in bath to cool them, jsut remove clothing, call ambulance if seizure lasting >5mins. Follow-up with physician.

History and Examination:

When did the jaundice develop? Extent of jaundice? Is the baby feeding, dehydrated, sick, lost significant weight? Is the baby full term? Was there trauma during birth? What are the mother’s and baby’s blood groups? Is the baby passing pale stools and dark urine? Did the baby’s siblings have similar problems? Is there a family history of haemolytic disease?

Initial Investigations:

FBC, UEC, LFT, CRP, Blood cultures, Urine MCS, Bilirubin (unconjugated/conjugated)

Then consider:

TFT
Alpha-1-antitrypsin
G6PD
Viral Serology
Abdominal USS

Causes of Unconjugated Hyperbilirubinaemia:

Physiological
Breast Milk Jaundice
Sepsis
GI Obstruction
Hypothyroidism

Causes of Conjugated Hyperbilirubinaemia:

Hepatitis
Biliary Atresia