Febrile Seizure

Febrile seizure, also known as a fever fit or febrile convulsion, is a convulsion associated with a significant rise in body temperature. It is the seizure (fits or convulsions) in children who is suffering from fever and doesn't have any neurological illness. Seizures that occur after vaccination are also included in this category. During a febrile seizure, a child often loses consciousness and shakes, moving limbs on both sides of the body. Less commonly, the child becomes rigid or has twitches in only a portion of the body, such as an arm or a leg, or on the right or the left side only. Usually the seizure does not last for more than 10 minutes and usually not more than one episode per febrile episode. After the attack of seizure is over, the patient recovers fully without any neurological deficit. The majority of children who experience febrile seizures have rectal temperatures greater than 102 degrees Fahrenheit. Most febrile seizures occur during the first day of a child's fever. Children prone to febrile seizures are not considered to have epilepsy, since epilepsy is characterized by recurrent seizures that are not triggered by fever. They most commonly occur in children between the ages of 6 months to 6 years and are twice as common in boys as in girls

Types of Febrile Seizures

A simple febrile seizure is one in which the seizure lasts less than 15 minutes (usually much less than this), does not recur in 24 hours, and involves the entire body (classically a generalized tonic-clonic seizure). Tonic clonic seizures involve a stiffening of the arms and legs (tonic phase), followed by jerking of the arms, legs, and head (clonic phase). Simple febrile seizures do not cause permanent brain injury; do not tend to recur frequently (children tend to outgrow them); and do not make the development of adult epilepsy significantly more likely (about 35%), compared with the general public (1%). A complex febrile seizure is characterized by longer duration, recurrence, or focus on only part of the body.

Causes of Febrile Seizure

Ear infections

Roseola infantum (a condition with fever and rash caused by several different viruses) Upper respiratory infections caused by a virus Gastroenteritis (stomach flu)

Certain conditions that can trigger off febrile convulsions or increase its chances :

High temperature and a rapid rise in temperature Frequent infections and illness Inherit from parents or genetically predisposed to it. If elder siblings have suffered from it. If the first attack of febrile convulsion was accompanied by a relatively low body temperature that is below 102 F. After receiving the MMR , but it is very rare.

Symptoms
A febrile seizure may be as mild as the child's eyes rolling or limbs stiffening. Often a fever triggers a full-blown convulsion that involves the whole body. Febrile seizures may begin with the sudden contraction of muscles on both sides of a child's body -- usually the muscles of the face, trunk, arms, and legs. The child may cry or moan from the force of the muscle contraction. The contraction continues for several seconds, or tens of seconds. The child will fall, if standing, and may pass urine. The child may vomit or bite the tongue. Sometimes children do not breathe, and may begin to turn blue. Finally, the contraction is broken by brief moments of relaxation. The child's body begins to jerk rhythmically. The child does not respond to the parent's voice. A simple febrile seizure stops by itself within a few seconds to 10 minutes. It is usually followed by a brief period of drowsiness or confusion. A complex febrile seizure lasts longer than 15 minutes, is in just one part of the body, or occurs again during the same illness. Or ETO :P

Brief seizures or fits Loss of consciousness Becoming stiff Stops breathing for about 30 seconds Loses control of their bladder or bowel Twitchings and spasms of face and mecles Rolling of the eyes upwards

Head is thrown backwards and arms and legs begin to jerk Skin becomes pale and sometimes turns blue for a few seconds Childs falls asleep after the fits stops and remains irritable and confused after waking up

Diagnosis
The health care provider may diagnose febrile seizure if the child has a grand mal seizure but does not have a history of seizure disorders (epilepsy). In infants and young children, it is important to rule out other causes of a first-time seizure, especially meningitis. In a typical febrile seizure, the examination usually shows no abnormalities other than the illness causing the fever. Typically, the child will not need a full seizure workup (which includes anEEG, head CT, and lumbar puncture (spinal tap)).

To avoid having to undergo a seizure workup: The child must be developmentally normal. The child must have had a generalized seizure, meaning that the seizure was in more than one part of the child's body, and not confined to one part of the body. The seizure must not have lasted longer than 15 minutes. The child must not have had more than one febrile seizure in 24 hours. The child must have a normal neurologic exam performed by a health care provider.

Treatment

During the seizure, leave your child on the floor. You may want to slide a blanket under the child if the floor is hard. Move him only if he is in a dangerous location. Remove objects that may injure him. Loosen any tight clothing, especially around the neck. If possible, open or remove clothes from the waist up. If he vomits, or if saliva and mucus build up in the mouth, turn him on his side or stomach. This is also important if it looks like the tongue is getting in the way of breathing. DO NOT try to force anything into his mouth to prevent him from biting the tongue, as this increases the risk of injury. DO NOT try to restrain your child or try to stop the seizure movements.

Focus your attention on bringing the fever down: Insert an acetaminophen suppository (if you have some) into the child's rectum. DO NOT try to give anything by mouth. Apply cool washcloths to the forehead and neck. Sponge the rest of the body with lukewarm (not cold) water. Cold water or alcohol may make the fever worse.

After the seizure is over and your child is awake, give the normal dose of ibuprofen or acetaminophen. After the seizure, the most important step is to identify the cause of the fever. Diazepam may be prescribed to prevent or shorten seizures in a child with fever. However, this is rarely prescribed because the medication can cause drowsiness and may mask the signs of serious infection. It is usually not necessary to give anti-epileptic drugs to a child who has febrile seizures, since the potential side effects probably outweigh the possible benefits. There is no evidence that giving anti-epileptic drugs will prevent the child from developing epilepsy later on.