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Paediatric GCS – verbal modification — RACP Paediatrics MCQ

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HardEmergencyPaediatric GCS – verbal modificationRACP Paediatrics

A 14-month-old with fever has a focal convulsion lasting 18 minutes followed by persistent right arm weakness. He is now haemodynamically stable and the seizure has stopped. Which classification and disposition are most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Complex febrile seizure requiring paediatric assessment for alternative pathology

Explanation lettering: B = shown as A · D = shown as B · E = shown as D · A = shown as E

A is correct. Focality, duration over 15 minutes and postictal focal weakness make this a complex febrile seizure and mandate paediatric assessment for CNS infection, structural disease or epilepsy risk. B ignores all three complex features. C rigors do not cause impaired consciousness and postictal weakness. D absence seizures are brief and non-convulsive. E breath-holding occurs with an emotional trigger and does not fit the prolonged focal event.

Reference: RCH Melbourne, Seizures: acute management: https://www.rch.org.au/clinicalguide/guideline_index/Seizures_-_acute_management/