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FEBRILE SEIZURES

 

Febrile seizures are the convulsions that occur in young children aged between 3 months to 3 years due to very high fever. Most of the febrile seizures last for 1-2 minutes. However, they can sometimes occur for a brief period of about a few seconds or may last for as long as even 15 minutes or more. Febrile seizures usually occur on the first day of the onset of fever.

Types

Febrile seizures are classified into the following two types:

  • Simple febrile seizures are the most common type of convulsions which can last from a few seconds to 15 minutes. They do not recur during a 24-hour period and are generalized.
  • Complex febrile seizures are the convulsions that last for longer than 15 minutes. They can occur multiple times during a 24-hour interval and are restricted to only one side of the child’s body.

Symptoms

Symptoms of febrile seizures include the following:

  • Twitching of the limbs or convulsions
  • Loss of consciousness
  • Vomiting and formation of foam in the mouth
  • Rolling back of the eyes

Additionally, simple febrile seizures may lead to confusion or tiredness after the seizure while complex febrile seizures may cause a temporary weakness in one arm or one leg.

Usually, after the seizures, the child may fall asleep for about an hour or more.

Causes

Febrile seizures occur when there is a rapid increase in the body temperature of the child associated with an infection or an illness. However, it is not linked to the severity of fever. Usually, febrile seizures occur even before the illness is recognized because they occur on the first day of the illness. The causes of febrile seizures may include:

  • Fever associated with viral infections (especially flu and roseola) or bacterial infections
  • Fever which occurs after vaccination especially MMR (mumps-measles-rubella)

Risk factors

A family history of febrile seizures is the major risk factor that increases the likelihood of a child to develop the condition.

Complications

Usually, febrile seizures do not produce long-term health issues. However, they can lead to anxiety in the parents or caretakers. Simple seizures do not cause brain damage, learning difficulty or mental retardation and they do not indicate a serious underlying problem.

Also, febrile seizures do not generally mean that the child has epilepsy, i.e. development of recurrent seizures. Recurrence of febrile seizures is more common if:

  • The child has developed febrile seizures even after a low grade fever
  • The seizures have developed very soon after the fever
  • The child is younger than 18 months when the febrile seizures have developed for the first time
  • There is a family history of seizures

Diagnosis

The diagnosis of this condition is based on the description given by the parents.

If the exact cause of the illness is not clear, then the doctor may recommend certain blood or urine tests.

The below-mentioned tests may be required in case of complex febrile seizures especially in children aged less than 12 months or if the symptoms are unusual:

  • Electroencephalogram is performed to check the electrical activity of the brain
  • Lumbar puncture is done to detect infections of the brain or spinal cord by examining the cerebrospinal fluid

In infants and young children, the other possible causes of febrile seizures such as meningitis should be ruled out.

Treatment

Simple febrile seizures stop within a few seconds to about 15 minutes even without treatment.

When the child develops febrile seizures the following measures should be taken by the parents or caretakers:

  • Put the child in recovery position (onto one side) to assist breathing.
  • Note down the length of seizures.
  • Do not put anything in the child’s mouth including medicines, as there is a risk of biting the tongue.
  • Do not control the movements associated with seizures.
  • Remove the nearby objects which can be unsafe to the child.

Call the doctor immediately if seizures do not stop even after 5 minutes or if the child is not breathing. Treatment of recurrent seizures involves anti-seizure medicines available in gel form usually for rectal application.

 

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