Dorothy FarrarFebrile seizures
Febrile convulsions are seizures that young children experience as part of febrile infections . In most cases, seizures go away on their own or can be stopped with an antispasmodic.
What are febrile seizures?
Febrile seizures are seizures in babies or young children who have contracted a fever. The seizures usually start at a body temperature of 38 degrees Celsius and are not caused by inflammation in the central nervous system.
There are two types of febrile seizures: the simple form with a seizure duration of less than 15 minutes and involving the whole body, and the complex form that requires control, which often lasts longer than 15 minutes, only affects parts of the body and tends to recur.
Affected children experience their febrile seizures most frequently in the second year of life. Simple febrile seizures are usually harmless. In the case of complicated forms or an increased tendency to seizures, a possible cause of the febrile seizures is often sought as part of further diagnostics.
causes
The exact causes of febrile seizures have not yet been definitively researched. The various diseases that cause the child to develop a fever of 38 degrees Celsius or more are considered to be contributory factors in the seizures. Typical are respiratory infections, otitis media, three-day fever or an infection of the digestive organs.
A family disposition, i.e. febrile seizures that have already occurred in other family members, is also discussed as a cause. In one out of three cases, a child later has another seizure. Research has shown that there are certain factors behind the recurrence of febrile seizures.
There is an increased risk if a child has frequent but short-lived fevers or was less than 18 months old when the seizure started. Several seizures at the first triggering fever as well as already existing disturbances in the area of the central nervous system can indicate an increased readiness for seizures with regard to febrile convulsions.
Diseases
- respiratory infection
- Epilepsy
When to the doctor?
In the case of febrile seizures in adulthood, a doctor should always be consulted. Other symptoms often appear, such as headaches and body aches , tiredness or stomach and intestinal problems. Bacteria and viruses are usually responsible for the symptoms, which are contagious if left untreated and also spread further in the organism.
Children around the age of 2 have simple febrile seizures that last about 15 minutes. This is considered a part of the development of the child’s immune and nervous systems. A doctor does not have to be consulted in these cases. However, if the febrile seizures last longer, a doctor’s visit is necessary. There is another illness that needs to be clarified.
Three-day fever is another children’s disease. This is associated with additional symptoms such as vomiting , nausea or diarrhea. Normally there is no need to see a doctor. However, if the parents have strong fears or are concerned about the child, they should speak to a doctor for further clarification.
A doctor should be consulted in the event of a particularly severe fever, recurring and long-lasting febrile convulsions. Inflammation in the brain is possible and, if left untreated, can lead to irreparable damage. If other symptoms such as impaired consciousness, dehydration or pain occur, a doctor must be consulted immediately.
diagnosis and course
Since febrile seizures are often over by the time the doctor arrives, the diagnosis is usually made on the basis of the parents’ description of the seizures. In the case of a simple seizure, only the diagnosis and treatment of the underlying disease that triggered the fever often follows. The suspicion of complicated febrile seizures can be refuted or confirmed by measuring brain activity as part of an electroencephalogram (EEG) performed after the seizure.
If the EEG is abnormal – usually also in the case of a seizure in the first year of life – blood tests and in many cases also a lumbar puncture follow to examine the child’s cerebrospinal fluid for pathogens, such as meningitis . In most cases, febrile seizures are harmless and resolve on their own without medical intervention.
The probability of a recurrence is about 30 percent. In complicated febrile seizures, an increased tendency to seizures and epilepsy (occurring later in about four percent of patients) must be considered.
complications
Although febrile seizures occur in only a small number of children and are a complication of infection, their course is usually uncomplicated. However, even with an uncomplicated febrile seizure, there is a slightly increased risk for the child of later suffering from epilepsy. In addition to uncomplicated febrile seizures, there is also what is known as atypical or complicated febrile seizures.
While in the uncomplicated form there is an immediate loss of consciousness and a one-off cramp lasting only a few minutes, the atypical febrile seizure is focal. Focal means consciousness is not immediately knocked out during the spasm. The seizure also lasts longer than 15 minutes and the seizures recur several times within 24 hours. The difference between the two forms of progression has a clear effect on the prognosis.
Usually, the prognosis for febrile seizures is good. There is no damage to the nervous system or delay in mental development. Only the risk of epilepsy occurring later is increased, especially in the atypical form of febrile seizures. A third of the children are at risk of a recurrence, i.e. the repetition of the febrile seizure up to the age of five. The younger the child was when the first attack occurred, the higher the risk of a recurrence. Febrile seizures are similar to certain seizures that can occur with meningitis or encephalitis. These must therefore be excluded in the differential diagnosis.
treatment and therapy
Harmless febrile seizures in particular terminate themselves after a short time, so that first aid essentially consists of calming the child and protecting it from injury during the seizure – but without holding it tightly. This is followed by classic therapies against the fever such as suppositories or calf compresses and the supply of liquid.
If the seizure lasts more than two minutes, febrile seizures should be interrupted with antiepileptic drugs (e.g. diazepam suppositories). An ambulance must be called if the seizure has not ended after five or a maximum of eight minutes or if it repeats itself. If there is a known tendency to febrile seizures, the pediatrician can also suggest seizure prophylaxis in which the feverish child is given diazepam in suppository form from 38 to 38.5 degrees Celsius.If the cause of a seizure is meningitis or another disease, treatment is aimed at eliminating or alleviating the underlying disease. If, in the course of the check-ups after complicated febrile seizures, epilepsy is found to be the triggering cause, appropriate therapy is also initiated – on the one hand to treat the epilepsy at an early stage and on the other hand to reduce the probability of further fever fights in the case of febrile infections as best as possible.
outlook and prognosis
Since a distinction is made between uncomplicated and complicated febrile seizures, this also results in different prognoses. Other factors also play an important role. In general, however, the prognosis for febrile seizures is very good. Although simple febrile seizures are a complication of an infectious disease, they do not lead to any particular impairment in the further mental and physical development of the child. There is also no increased mortality.
In about 30 percent of children, febrile seizures occur repeatedly up to the age of five. Nevertheless, they represent a slightly increased risk. Around one to two percent of those affected develop epilepsy later on. In the case of complicated febrile seizures, the prognosis may be less favorable. Other factors play a role here. If there are already cases of epilepsy in the family or if the child has previously shown neurological abnormalities, the risk increases. In these cases, the probability of developing epilepsy increases to 30-35 percent.
prevention
A primary prevention of febrile seizures is usually not possible – unless a cause triggering the seizures, such as epilepsy, has already been diagnosed in advance. If there is an increased likelihood of febrile seizures – for example, if there is a frequency of seizures in the family or if the child has had a seizure at a very young age – measures to reduce the fever (suppositories, calf compresses) should always be taken to prevent a seizure in the case of a feverish illness. If the tendency to cramps is high, the pediatrician can also prescribe a medication to prevent febrile seizures.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.