Traps

[sirengirl]

So, I know it's been about 284729483 years since I've posted on the forum, just being so wrapped up in getting my medic class done. I'm in the ride times of my class now, should be done in a week. I literally just ran a call on a pediatric seizure, 3 witnessed seizures with full tonic-clinic while with EMS. When the mom got to the ER, she proceeded to tell the nurses that the kid has a rare genetic condition called TRAPS. From what I can gather on a quick search on my phone, it's an autoimmune disorder where the patient will randomly suffer fevers lasting weeks with rash and muscle aches, etc.

My question is, if anyone knows anything about TRAPS, are the seizures related or is that a different animal all together? Pt had no hx of seizures.

 

[Meursault]

I know nothing about TRAPS, but could these have been febrile seizures? Not seeing anything for TRAPS causing seizures on its own, nor for seizures from the amyloidosis it can cause. It's also autosomal dominant, so no reason to imagine the kid won the special suffering-and-funny-looks lottery you enter when your parents are consanguineous.

I'd say TRAPS is only sort of an autoimmune disorder; it's a disorder of inappropriate activation of all the stuff that gets released after the immune system meets an antigen, but there's no self-reactivity. The papers use "autoinflammation", which hits the key point.

 

[Jon]

First thing that came to mind:
[YOUTUBE]piVnArp9ZE0[/YOUTUBE]

I'm actually curious about this... and I'm sorry, but I don't have anything real constructive to offer, other than a "welcome back" to SirenGirl!

 

[Merck]

Hey,

I'm sure I'll get roasted for saying this but to be honest, I wouldn't worry about it. TRAPS can be easily found a search on a medical site and on Up To Date the article is one of the smallest I've seen. It's possible that perhaps the seizures themselves were related to the fever which is listed as the predominant finding. Remeber that the seizure is generally related to the rate of rise, not strictly the temp itself.

The main thing to remember with pediatric seizures is no different than any other call - ABCs and prevent further harm. With kids be sure to look for treatable causes (toxidromes, trauma, fever) as these can be the most useful things to determine. When it comes to the weird and wonderfuls don't lose much sleep over them. I've personally never heard of TRAPS in 18 years. Also remember that for the weird and wonderfuls the parents are the best resource as they know their kid and will certainly know more about the specific disease than the medics (or likely ER doc).

So while not trying to discourage the learning about the specifics I would say to make sure you keep focusing on the most important aspects. You also may want to include a more pointed question or phrase in your history questioning so that next time a parent tells you the specific dx first - then you can google it on the way and arrive looking like a star!

 

[JPINFV]

First thing that came to mind:
[YOUTUBE]piVnArp9ZE0[/YOUTUBE]

I'm actually kinda of ashamed that the first thing I though of was "trap" in the 4chan sense of "trap."

 

[bigbaldguy]

Also nothing to add except

Welcome back tiny feet

 

[sirengirl]

Thanks guys for all the "welcome-backs" I'm gonna be trying to post a lot more again...

As for those who said febrile, the first thing we checked (after airway) was the temp, it was about 99.2 on the eardrum. No hx of a flare up recently. The mom said that there had only ever been the one seizure x3 mos ago, and that seizure was accompanied by cerebral edema that the docs at the regional pedi center couldn't explain...

Just trying to figure out the possibility of perhaps a new onset epliepsy even in the absence of febrile symptoms? Idk the whole thing threw me for a loop. Figured others would be interested as well.