Febrile seizures are fits that is associated with a significant rise in body temperature in children ages of six months to five years. Febrile seizures are also known as fever fits or febrile convulsion.
During simple febrile seizures, the body will become stiff and the arms and legs will begin twitching. Also, the eyes roll back. The patient loses consciousness, although their eyes remain open. Breathing can be irregular. They may become incontinent (wet or soil themselves); they may also vomit or have increased secretions (foam at the mouth). The skin may appear to be darker than normal during an episode. The seizure normally lasts for less than one minute, but uncommonly can last up to fifteen minutes.
The direct cause of a febrile seizure is not known; however, it is normally precipitated by a recent upper respiratory infections or gastroenteritis. A febrile seizure is the effect of a sudden rise in temperature (>39°C/102°F) rather than a fever that has been present for a prolonged length of time. Febrile seizures represent the meeting point between a low seizure threshold (genetically and age-determined; some children have a greater tendency to have seizures under certain circumstances) and a trigger, which is fever. Fever most of the time accompanies respiratory illnesses such as influenza, pneumonia, ear infections, sore throats, and colds. It can occur also with various viral illnesses. The genetic causes of febrile seizures are still being researched. Some mutations that cause a neuronal hyper excitability (and could be responsible for febrile seizures) have already been discovered. Several genetic associations have been identified.
The diagnosis is one that must be arrived at by eliminating more serious causes of fits and fever: in particular,meningitis and encephalitis must be considered. If a child has recovered and is acting normally, bacterial meningitis is very unlikely. The diagnosis of a febrile seizure should not prevent evaluation of the child for source of fever, although this is usually limited to evaluation of the urine in the younger age groups.
There are two types of febrile seizures.
• A simple febrile seizure is one in which the seizure lasts less than 15 minutes (usually much less than this), does not recur in 24 hours, and involves the entire body (classically a generalized tonic clonic seizures).
• A complex febrile seizure is characterized by longer duration, recurrence, or focus on only part of the body.
Simple febrile seizures are more likely to be harmless that they do not cause brain damage nervous system problems, mental retardation, paralysis, or death, but should be reported immediately to the child specialist or child neurologist. They do not tend to recur frequently (children tend to outgrow them); and do not make the development of adult epilepsy. Children who are younger than one year old that have a simple febrile seizure have a 50 percent chance of having another seizure. Children older than one year old have a 30 percent chance of a second seizure.
Children with complex febrile convulsions are more likely to suffer from a febrile epileptic attacks in the future if they have a complex febrile seizure, a family history of a febrile convulsions in first-degree relatives (a parent or sibling), or abnormal neurological signs or developmental delay.
Investigations are required in few children’s after clinical assessment like, lumbar puncture for cerebrospinal fluid examination, CT/MRI of brain, EEG.
The vast majority of patients do not require treatment for either their acute presentation with a seizure or for recurrences. Children have a rectal temperature of 100.4 degrees Fahrenheit or higher have a fever.
The best way to manage is to control the temperature with acetaminophen. Acetaminophen should be based on a child’s weight not his age. Ask your doctor for the appropriate dosage. It is not recommended to use aspirin to treat a simple fever.
Another way to manage is to combine medication with sponging or just use sponging alone.Place your child sitting down in a regular bathtub with slightly warm water. Cold water can cause shivering, which raise the child’s temperature. Then sponge water all over the body until the temperature reached a good level.
In the home, diazepam rectal suppository medication can be used to control fits immediately. Drugs like diazepam and clobazam can be used during episodes of fever till 5 years of age. Daily medications may be needed in few children after detailed assessment of fits, development, examination, and investigations.