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Febrile Seizures

Febrile Seizures refer to generalized convulsions or spasms in children when they have a high fever. During an episode, the child may suddenly extend or convulse their entire body, experience facial muscle twitching, roll their eyes upward, and lose consciousness. The seizure typically lasts only two to three minutes and then naturally stops. This phenomenon occurs in approximately 5% of infants and young children, usually between 6 months and 5 years.

Symptoms

Febrile seizures typically occur in young children during a high fever and are more likely to happen in the early stages of a rise in body temperature. The symptoms include:

Generalized convulsions: Sudden onset involving the entire body, including limbs and facial muscles.
Body straightening or bending: The child's posture during the seizure may involve the body suddenly straightening or curling.
Facial muscle twitching: Facial muscle twitching may accompany the seizure, resulting in irregular facial expressions.
Eye rolling: The eyes may roll upward, a common feature of seizures.
Loss of consciousness: During the seizure, the child may lose consciousness or be confused.
Brief duration: Febrile seizures are typically short, lasting within two to three minutes and not exceeding 15 minutes.
Spontaneous cessation: Seizures usually stop spontaneously within a short period and do not require specific medical intervention.
Respiratory changes: Breathing may vary during the seizure, but it typically does not cause respiratory distress.

While febrile seizures may appear concerning, they are generally benign and do not have adverse effects on the child's long-term health. However, any occurrence of febrile seizures in children should prompt seeking medical assistance to ensure proper evaluation and management.

Factors

Febrile seizures are a common pediatric condition that typically occurs in children between 6 months and five years of age. The leading cause is related to the immature development of the brain. During the brain development process, it is more sensitive to temperature, so symptoms such as brief seizures and convulsions may occur when faced with fever and a rapid increase in body temperature.

Here are some possible causes:

Rapid Increase in Body Temperature	Febrile seizures are usually associated with a rapid rise in body temperature. When a child's body temperature rises sharply to a certain level, it may trigger excessive excitation of neurons, leading to seizures.
Genetic Factors	Any illness that causes high fever, such as infectious diseases, can lead to generalized convulsions. Common examples such as Roseola, Urethritis, Tonsillitis, Influenza A, Otitis media, Gastroenteritis. Severe conditions may involve diseases like Encephalitis and Meningitis.
Infections	Febrile seizures are commonly triggered by fever-inducing infections, especially respiratory infections. Viral or bacterial infections can cause fever, which may lead to seizures.
Rate of Fever Increase	Some research indicates that febrile seizures may be related to the rate of fever. The risk of seizures may increase when body temperature rises rapidly.
Epilepsy	A small percentage of children who experience febrile seizures have epilepsy (about 3%) .

For patients with benign (typical) febrile seizures, excluding causes such as central nervous system infections, most will recover with age. The majority of patients do not develop epilepsy, and it does not impact intellectual development.

Diagnosis and Treaments

Doctors will determine the cause of fever and seizures based on the medical history and physical examination.

Standard examinations include nasal fluid analysis, throat bacterial culture, blood tests, urine tests, chest X-rays, etc.
A lumbar puncture may be necessary for cerebrospinal fluid analysis if meningitis is suspected.
If needed, doctors may arrange additional tests such as electroencephalogram (EEG), computed tomography (CT) scan, magnetic resonance imaging (MRI), etc.
In severe cases, hospitalization may be recommended for further examination and treatment.

Doctors will treat the underlying cause and may use antipyretic medications. If bacterial infection is suspected, antibiotics or anticonvulsant drugs may be prescribed to shorten the duration of seizures, but it is essential to follow the doctor's prescription and instructions carefully.

FAQ

Benign febrile seizures generally resolve within 15 minutes. However, in the following complicated situations, it is advisable to promptly take the child, along with information on medication history and medical records, to the Accident and Emergency Department (A&E) for consultation: - The child's age is less than 6 months. - Seizure duration exceeds 15 minutes. - Seizures only affect specific body parts, and the involvement is asymmetrical. - Recurrent seizures. - After the seizure stops, the child remains disoriented. - After the seizure stops, paralysis of the hands or feet, headache, difficulty breathing, pallor, or blueness of the face. - Presence of hemorrhagic rash. - Stiff neck or signs of meningitis. - Difficulty swallowing, sore throat, excessive drooling. - Severe vomiting, diarrhoea, abdominal pain, lower back pain, dehydration. - Accidental ingestion of medication or suspected poisoning. - Head injury leading to unconsciousness within the past three days before the onset of seizures. - Any age, with a body temperature reaching or exceeding 40°C (104°F).

- Place the child safely, avoiding contact with complex objects or falling from the bed. - If there is no neck injury, lay the child flat, then turn the head to the side to help clear secretions from the mouth. - If foreign objects block the airway, immediately clear it and loosen the collar. - In case of vomiting, promptly clean up the vomit to prevent the child from inhaling it into the trachea. - If accompanied by high fever, use rectal antipyretic medication. - If instructed by a doctor beforehand, use rectal anticonvulsant medication. - Wiping the body with warm water and removing thick clothing helps reduce fever and shorten the duration of seizures. - Avoid intense light stimulation to the child. - Observe the seizure.

- Check the breathing, and heartbeat. - Comfort the child after awakening and allow the child to rest. - After the child is fully awake, administer oral antipyretic medication or give water. - Record details of the fever and seizure. - Pay attention to the appearance of other symptoms, such as rash, flu-like symptoms, sore throat, or stiff neck. - When seeking medical attention, inform the doctor of the child's past and family history of seizures, medication use, and other symptoms.