Febrile convulsions occur in 2-4% of all children, about 50% of them have first seizure between the first and second year of life. Slightly more common in boys. Positive family history is very important information, because incidence is increased in a positive family history.
Febrile convulsions (febrile seizures) are convulsions that occur at when the temperature is high, over 101ºF, usually in children in the age form 6 months to 6 years, but diagnostic procedures must clearly exclude the existence of any infection of the central nervous system (meningitis, encephalitis) or the presence of acute or chronic neurological diseases.
Febrile convulsions occur in 2-4% of all children, about 50% of them have first seizure between the first and second year of life. Slightly more common in boys. Positive family history is very important information, because incidence is increased in a positive family history.
The probability of repeated attacks after the first episode is great, in 30-40% of children. Risk factors are febrile seizures that begin in the first year of life, family predisposition for febrile convulsions, attacks that happen at a lower temperature (up to 38, 5 ° C), epilepsy in relatives, complex febrile convulsions, disorder in psychomotor development, and short period of illness before the occurrence of febrile seizures. Half of recurrences of febrile seizures are occurring within 6 months, 75% within the year, and 90% within two years of the first attack. Based on numerous clinical studies and evidence that we have, the risk for epilepsy in children who had febrile seizure is identical to that in the group of children who do not have febrile convulsions . Those children aren't different not even a little bit in terms of possibility for developing epilepsy.
Signs are very dramatic and frustrating for any parent. There is almost no parent who come to ER that didn't say a sentence: "It seemed as if we lose him, we thought it was over .... he has numbed for few minutes, for example, for 15 minutes he did not respond to calls. Time which is usually counted in seconds, for terrified and worried parents lasts much longer, because the situation is really dramatic and serious, something they have never experienced before.
Encouraging factor for all parents is that most attacks end spontaneously after a few minutes. If the attack lasts longer, it is interrupted with diazepam suppositories for rectal administration (sedative) which takes effect with in first 10 minutes of application. Prophylactic therapy (which will child take regularly as protection) is given in repeated and atypical attacks and it is prescribed by child's neurologist.
Febrile convulsions occur in 2-4% of all children, about 50% of them have first seizure between the first and second year of life. Slightly more common in boys. Positive family history is very important information, because incidence is increased in a positive family history.
What is the cause of febrile convulsion
The etiology is still not fully known. The possible cause can be lowered tolerance to elevated temperature which is in correlation with underdevelopment thermo-regulatory center in children, and very high temperatures can act as a trigger for seizures in the immature children's brain .The probability of repeated attacks after the first episode is great, in 30-40% of children. Risk factors are febrile seizures that begin in the first year of life, family predisposition for febrile convulsions, attacks that happen at a lower temperature (up to 38, 5 ° C), epilepsy in relatives, complex febrile convulsions, disorder in psychomotor development, and short period of illness before the occurrence of febrile seizures. Half of recurrences of febrile seizures are occurring within 6 months, 75% within the year, and 90% within two years of the first attack. Based on numerous clinical studies and evidence that we have, the risk for epilepsy in children who had febrile seizure is identical to that in the group of children who do not have febrile convulsions . Those children aren't different not even a little bit in terms of possibility for developing epilepsy.
Signs and Symptoms of Febrile convulsion
Febrile seizures are most often manifested in sudden jump in temperature which is greater than 38,5 ° C, it is often the first symptom of the illness. Usually parents give information that they did not notice a fever before the seizures or the temperature is not getting down, even with the use of antipyretics. Among the most common causes of elevated temperature, which may lead to the appearance of febrile seizures are viral upper respiratory tract infections (influenza type A, parainfluenza, adenovirus), bacterial infections of gastrointestinal tract (shigellosis), urinary tract infection and acute inflammation of the middle earSigns are very dramatic and frustrating for any parent. There is almost no parent who come to ER that didn't say a sentence: "It seemed as if we lose him, we thought it was over .... he has numbed for few minutes, for example, for 15 minutes he did not respond to calls. Time which is usually counted in seconds, for terrified and worried parents lasts much longer, because the situation is really dramatic and serious, something they have never experienced before.
What kind of seizures are there?
There are two types of attacks: typical and atypical febrile convulsions.- Typical or simple febrile seizures are generalized seizures in children aged from 1-5 years, lasting less than 15 minutes and not repeating within 24 hours. Symptoms are:
- turned and fixed sight to one side,
- loss of conscience,
- shacking,
- lips can turn blue and
- short interrupted breathing.
- Atypical or complex febrile seizures are focal or semi -generalized (they affect one-half of the body) attacks lasting longer than 15 minutes, occurring several times a day. The child feels exhausted after each attack. During attacks it never comes to incontinence.
How is it diagnosed?
The diagnosis is set with taking a detailed medical history about the type of attack, duration, position of the body, as well as excluding the acute infection of the central nervous system - meningoencephalitis. In order for better diagnosis it is essential that parents stay calm, as much as they can, at the time of the seizure to be able to describe exactly what happened and how it looked like. If we suspected one CNS infection we are doing blood tests, as well as lumbar puncture, especially if the child is younger than a year, and clear cause of fever is not defined. EEG recording are not done routinely in children with typical febrile convulsions.What to do when your child is having a seizure!
A child who has febrile seizures should be put on one side to avoid swallowing of the tongue. It is not necessary to open child's mouth by force, nor slapping a child, as parents tend to do, because it will not help. (the number of children who arrives fully recovered to pediatric clinic after the attack arrives fully recovered, but with a large red fingerprint of hands is unbelievable!!! ). You must take all available measures to lower the temperature - antipyretics, cooling child with lukewarm water coverings and frequent showering.Encouraging factor for all parents is that most attacks end spontaneously after a few minutes. If the attack lasts longer, it is interrupted with diazepam suppositories for rectal administration (sedative) which takes effect with in first 10 minutes of application. Prophylactic therapy (which will child take regularly as protection) is given in repeated and atypical attacks and it is prescribed by child's neurologist.
The outcome!
Prognosis for typical febrile convulsions is excellent. After the initial shock, that your child survived a dramatic febrile seizures, after talking with your doctor and neurologist most parents will realize that their child is developing normally and even though this have shorten few years of your life id didn't effect on child's brain. Although the first records of the febrile convulsions at elevated temperature in infants and child date more than 2000 years ago, doctors to this day can not find a way how to explain parents that this is a transitory state, which seems to be much more stressful and dramatic than actually dangerous for your child, that it will pass and that you can get all the necessary information and advices on what to do if seizure happen again, and what to pay attention on from your pediatrician.
That is actually the goal of this text:
If your child has a fever, lower it by showering with lukewarm water coverings and antipyretics, watch what part of the body is writhing ,are his eye fixed on one side, how long does it last. Do not hit the child on the face, it will not shorten the time of the attack. Be sure that if repeated attack do happen, after a conversation with your pediatrician you will know what need to do, which medications to apply and you will realize that it is not as scary as it looks.
Text: Milena Nikolic MD
Translator: Vladimir Comagic MD
That is actually the goal of this text:
If your child has a fever, lower it by showering with lukewarm water coverings and antipyretics, watch what part of the body is writhing ,are his eye fixed on one side, how long does it last. Do not hit the child on the face, it will not shorten the time of the attack. Be sure that if repeated attack do happen, after a conversation with your pediatrician you will know what need to do, which medications to apply and you will realize that it is not as scary as it looks.
Text: Milena Nikolic MD
Translator: Vladimir Comagic MD
Source:mojpedijatar
Image:courtesy of Sura Nualpradid at FreeDigitalPhotos.net
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