A febrile seizure is a convulsion triggered by a fever. It is the most common type of seizure in healthy children, occurring in one in 25 children, and is most commonly seen in children aged between six months and five years. And as per data by the National Institute of Neurological Disorders and Stroke, febrile seizure occurs in two to five percent of American children aged five and younger.
The seizure affects the limbs on both sides of the body and may be accompanied by loss of consciousness. Read this post to know more about the types, causes, symptoms, diagnosis, treatment, and prevention of febrile seizures in children.
Types Of Febrile Seizures In Children
Febrile seizures in children can be classified into the following two types.
1. Simple febrile seizures
- Most of the febrile seizures in children are simple febrile seizures.
- These last for less than 15 minutes.
- Shaking is seen on both sides of the body.
- They do not occur more than once in a 24-hour period.
2. Complex febrile seizures
- These are less common and may last for more than 15 minutes.
- Shaking happens on only one side of the body.
- They may occur more than once in a 24-hour period.
Causes Of Febrile Seizures In Children
- Rapidly increasing fever
- Viral infections, such as common cold, or upper respiratory infections that cause fever
- Bacterial infections, such as urinary tract infections, ear infections, or other infections, that cause fever
- Familial tendencies
- Genetic factors
Signs And Symptoms Of Febrile Seizures
- Upward rolling of the eyes
- Stiffening of limbs
- Muscle contractions lasting for several seconds or longer on both sides of the body
- Crying or moaning
- Falling from the standing position
- Tongue biting
- Breathing problems and cyanosis (turning blue)
- Rhythmic jerking of the child’s body
- Not responding to the parents’ voice
- Passing urine
Note that the symptoms may vary in each child. Further, these symptoms may also be seen in other conditions, such as meningitis. Thus, always consult a doctor for the right diagnosis and treatment.
Complications Of Febrile Seizures
- It is estimated that children with a history of simple febrile seizures have a one in 50 chance of developing epilepsy at some point in the future.
- Those with a history of complex febrile seizures have a one in 20 chance of developing epilepsy at some point in the future.
- Those with no history of febrile seizures also have a one to two in a 100 chance of developing epilepsy.
Diagnosis Of Febrile Seizures In Children
In a typical febrile seizure, the doctors may not recommend a full seizure workup if there are no other symptoms of the illness apart from the fever.
A full seizure workup is advised in the following scenarios.
- The child is younger than nine months or older than five years
- History of a brain, nerve, or developmental disorder
- Seizures occur only on one side of the body
- A seizure lasting for longer than 15 minutes
- More than one febrile seizure in 24 hours
A full seizure workup may involve an EEG (electroencephalogram), head CT scan, MRI (magnetic resonance imaging), and lumbar puncture (spinal tap).
Testing for the underlying pathology causing fever
Some fevers may have serious underlying causes. And a thorough medical and physical history after an episode of a febrile seizure may pinpoint conditions such as
Spinal taps may be performed to confirm or rule out the diagnosis of these conditions.
Tests to understand the risks associated with seizures
Children with complex febrile seizures are at a higher risk of developing epilepsy. The following tests help in assessing the risk for epilepsy.
- Electroencephalogram (EEG)
This test uses electrodes to record brain waves to gauge the risk of recurrence of a seizure. It is a painless procedure.
- Brain scans
A CT scan or MRI creates detailed images of the brain. It helps in detecting the underlying cause that may lead to seizures in children.
When To Call A Doctor
Call the local emergency number if you notice a seizure lasting for several minutes. Inform the emergency service to get an ambulance along to carry the child to a hospital. If the seizure ends quickly, you can drive the child to the nearest hospital.
You must contact the doctor if the child has repeated seizures of a similar kind or seizures that appear to be of a new kind.
Along with seizures, if you notice any of the following symptoms, call the doctor.
- Abnormal movements
- Disoriented coordination
Treatment And Management Of Febrile Seizures In Children
Managing the child while a febrile seizure is happening
During a seizure episode, parents must stay calm, get help if needed, observe the child, and avoid any restraints.
You may follow these steps.
- Lay the child on one side as it allows secretions to drain from the mouth.
- Lay the child on a flat surface and make sure that there are no toys or sharp objects around as they may cause a physical injury.
- Do not try to put anything in the child’s mouth during the episode.
- Watch out for signs of breathing problems such as bluish discoloration of the skin (cyanosis).
- Try to gauge how long the seizure l Most seizures end within 30 seconds to two minutes.
The doctor may prescribe medicines to end the seizure. The medicines are usually administered rectally. The doctor or nurse will train you on how to administer these medicines rectally.
After the seizure, focus on the underlying causes of fever and ways to bring the fever down.
The children might feel sleepy, tired, confused, or agitated after the seizure. Be composed and let them rest.
Preventing Febrile Seizures In Children
Although febrile seizures cannot be prevented, doctors might prescribe diazepam to prevent or treat recurrent febrile seizures.
The risks of developing epilepsy after a fever are low, and therefore, anti-seizure medicines are not prescribed to prevent recurrent febrile seizures. In some cases, the doctors may prescribe a short-term benzodiazepine bridge. It is given to children when they have a fever and a history of recurrent febrile seizures.
Febrile seizures are not a cause for worry in most cases, but they might be a scary event for the parents and caregivers when they occur. Most children outgrow them by the age of five years, and the condition does not affect the child’s ability to learn and grow either at home or school.
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