Febrile seizure as the name indicates refers to convulsions (fits) that can occur in a child at the time of a febrile illness.It can be quite frightening but most of the episodes last only for a few seconds without leaving any permanent damage.
A brief guide on febrile seizures...
Who can get febrile seizures?
Children aged between 6 months to 5 years are susceptible.The most common age group is less than 2 years.
What causes these seizures?
Typically thought to be due to sudden high temperature and underlying infections.An episode generally occurs in the first 24 hours of onset of fever.Children who have febrile seizures tend to have a rectal temperature that’s higher than 102 degrees Fahrenheit.
A positive family history is a strong risk factor as well history of one previously.
The risk of febrile seizures may increase after some childhood vaccinations such as DPT or MMR. But remember that it is the fever and not the vaccines that cause the convulsions.
How do I recognise one?
The child would have high grade fever with shaking of a part or whole of the body.Sometimes,there is loss of consciousness. Take note of the following:
Biting of the cheek or tongue.
Rolling of the eyes
Clenching of the teeth or jaw
Losing control of urine or stool.
There are two types of febrile seizures:
1.Simple seizures: last for a few seconds,do not recur for another 24 hours and not localised to one part of body.
2.Complex seizures: typically lasts for more than 15 minutes,have a propensity to recur within the next 24 hours and is confined to one side of the body.
What should I do if my child develops an episode of febrile seizure?
Do not panic.
Gently place the child on the floor or a hard surface and turn the head to one direction.
Remove any objects in the child's mouth carefully to prevent aspiration.
See that there are no tight clothing around the neck.
If possible note the duration of the episode.
Get medical help once the seizures stop.
Treatment and prophylaxis
Tepid sponging and antipyretic medications mainly paracetamol are the key to management. Aspirin must be avoided in children. Anticonvulsant medications might be given per rectally for seizure control in case of complex seizures but are rarely needed in long term.
Children with history of prolonged febrile seizures and those who live in more remote areas with poor access to prompt medical care should be given a rescue medication.The most commonly used among these would be diazepam for per rectal use.Giving diazepam at the onset of illness or fever can prevent further attacks also but is not given in all cases.
Commonly asked questions
1.Can febrile seizures progress onto epilepsy in the future?
Just because your child had an episode of febrile seizure has no bearing on development of seizure disorder later. In the event that he/she has multiple risk factors with complex seizures,the future risk is slightly more.
2.Are febrile seizures hereditary?
Febrile seizures can run in the family. So,if the elder sibling has a positive history,it has to be anticipated in the child when he gets a febrile illness.
3.Why is it that my child's fever is not coming down inspite of administering paracetamol as advised by the paediatrician?
Do check if you are giving the correct dosage appropriate to his/her age. It is quite common to see that parents give dosage as per what the paediatrician had advised months ago.Your child's weight increases over time,so should your medication dose too!
Remember-Febrile seizures are unpredictable to an extent and hence temperature control should be of primary concern in any fever. Stay calm but be aware of what not to be done in case they occur. Always contact your paediatrician if febrile seizures develop.
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