Febrile Seizure

Overview

A febrile seizure is a convulsion in a child that occurs due to a fever, typically caused by an infection. These seizures are common in young, healthy children with normal development who haven't experienced any neurological symptoms before. Febrile seizures usually last a few minutes, are harmless, and don't signify a serious health issue. They can involve a loss of consciousness, shaking of the arms and legs, or stiffness in a particular area of the body. Although frightening, most febrile seizures have no lasting impact on the child's health. It is essential to consult a doctor after a febrile seizure to have the child evaluated and to address any concerns.

Understanding the disease

Symptoms

A febrile seizure is a convulsion in a child caused by a fever, typically from an infection. Symptoms include:

1. Loss of consciousness
2. Shaking or jerking of the arms and legs
3. Fever higher than 100.4 F (38.0 C)
4. Stiffness or twitching in one area of the body Febrile seizures are usually harmless, last only a few minutes, and don't indicate a serious health problem. However, it's important to have your child evaluated by a doctor as soon as possible after a febrile seizure.

Risk Factors

The risk factors for developing a febrile seizure include:

1. Young age: Most febrile seizures occur in children between 6 months and 5 years of age, with the highest risk between 12 and 18 months of age.
2. Family history: Some children inherit a tendency to have seizures with a fever. Additionally, certain genes have been linked to a susceptibility to febrile seizures.
3. Fever: Having a high fever, particularly a fever higher than 100.4 F (38.0 C), increases the risk of a febrile seizure.
4. Rapidly increasing fever: A fever that rises quickly, especially if it goes above 104 F (40 C), may trigger a febrile seizure.
5. Previous febrile seizures: Children who have experienced a febrile seizure before are more likely to have another one.
6. Infections: Viral infections, particularly those accompanied by high fevers, like the flu or roseola, can trigger febrile seizures.
7. Vaccinations: Certain childhood vaccinations, such as the diphtheria, tetanus, and pertussis vaccine (DTaP) or the measles-mumps-rubella vaccine (MMR), may increase the risk of a febrile seizure following vaccination. It's important to note that the seizure is caused by the fever, not the vaccine itself. Keep in mind that most febrile seizures are harmless and do not have lasting effects. If your child experiences a febrile seizure, it's essential to seek medical attention to rule out any underlying concerns and to discuss prevention strategies.

Development

Febrile seizures develop as a result of a fever in young, healthy children who have normal development and haven't had any neurological symptoms before. The seizures are caused by a rapid increase in body temperature, which can trigger abnormal electrical activity in the brain.

Assessment and Diagnosis

Triage

You should see a doctor as soon as possible after your child's first febrile seizure, even if it lasts only a few seconds. Call your child's doctor or an ambulance to take your child to the emergency room if the seizure lasts longer than five minutes or is accompanied by vomiting, a stiff neck, breathing problems, or extreme sleepiness.

Diagnosis

To diagnose a febrile seizure, a healthcare professional will review your child's medical history and developmental history. Identifying the cause of the fever is the first step after a febrile seizure. In normally developing children, the doctor can diagnose a simple febrile seizure based on history. However, if your child has a delayed vaccination schedule or a compromised immune system, the doctor may recommend tests to look for severe infections, such as a blood test, a urine test, or a spinal tap (lumbar puncture) to check for central nervous system infections like meningitis. For complex febrile seizures, an electroencephalogram (EEG) and/or a Magnetic resonance imaging (MRI) may be recommended to check for brain abnormalities or increased pressure in the skull.

Management and Treatment

Complications

Potential complications of a febrile seizure include the possibility of more febrile seizures, particularly in children who have had a previous seizure, or if the fever was low-grade or the first sign of illness. However, most febrile seizures are harmless, and they do not usually cause brain damage, intellectual disability, or learning disabilities. Simple febrile seizures last from a few seconds to 15 minutes, are not specific to one part of the body, and occur only once within a 24-hour period. Complex febrile seizures are longer than 15 minutes, occur more than once within 24 hours, or are confined to one side of the body. If a seizure lasts longer than five minutes or is accompanied by vomiting, a stiff neck, breathing problems, or extreme sleepiness, it is important to seek immediate medical attention.

Prevention

Febrile seizures are usually harmless and don't indicate a serious health problem, but they can be frightening for parents. Most febrile seizures occur during the initial rise in body temperature, often in the first few hours of a fever. Although medications like acetaminophen or ibuprofen can help reduce fever, they won't prevent a seizure. Preventing the underlying fever caused by infections is the best way to reduce the risk of a febrile seizure. Vaccinations, following public health guidelines for wearing masks and social distancing, and proper hygiene practices can help prevent the spread of infectious diseases. However, it's important to note that not all febrile seizures can be prevented, as they are often caused by viral infections or other factors beyond personal control. If your child experiences a febrile seizure, it's crucial to seek medical attention for evaluation and guidance on appropriate care and prevention measures.

Home Remedies

There are no specific home remedies suggested for febrile seizures. The primary focus should be on managing the fever that triggers the seizure. Giving your child acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) can help lower the fever and make them more comfortable. However, these medications won't prevent seizures. If a seizure occurs, it's crucial to ensure the child's safety, remove any sharp objects from the surroundings, and avoid putting anything in the child's mouth. After the seizure, comfort the child and seek medical attention as soon as possible. It's essential to consult with a healthcare provider for proper evaluation and guidance on managing febrile seizures.

Treatment

If your child experiences another febrile seizure, you should:

1. Place your child on a safe surface, such as the floor.
2. Place your child on his or her side, keeping the face to the side and the lower arm extended under the head, to prevent your child from inhaling vomit if vomiting occurs.
3. Remove any objects from your child's mouth if something was in there during the seizure.
4. Call for emergency medical attention if the seizure lasts more than five minutes, there are repeated seizures, or if the child is not improving quickly. If the seizure is prolonged, the child is younger than 6 months old, the seizure is accompanied by a serious infection, or the source of the infection can't be found, your child's doctor may hospitalize them for observation. It's essential to consult with a doctor for proper diagnosis and treatment recommendations. Your doctor can provide guidance on how to manage and potentially prevent future febrile seizures.

Preparing for medical consultation

To prepare for an appointment for a febrile seizure, you should:

1. Record information about the seizure, including the time, location, symptoms experienced, and duration.
2. List any medications, vitamins, or supplements the child is taking.
3. Write down questions to ask the doctor, such as the most likely cause of the seizure, necessary tests, and treatment options.
4. Be aware of any pre-appointment restrictions or requirements for medical tests.
5. Note any major stresses, recent life changes, or other health conditions the child may have.
6. Write down key personal information, including any medications you are taking.
7. Prepare a list of questions to ask the doctor, such as the most likely cause of the seizure, necessary tests, and treatment options. At the appointment, be prepared to answer questions about the child's seizure, any accompanying symptoms, and previous occurrences. Additionally, discuss the child's medical history and any medications they are currently taking. Take notes and don't hesitate to ask for any additional information or resources provided by the doctor.