Febrile Seizure

What is febrile seizure?

• Febrile seizure is a convulsion that occurs among children aged between 6 months and 5 years who develops fever with body temperature above 100.4 F(38C).Peak age of having it is 12-18 months. It is the most common type of seizure that is triggered by fever. 
• During the convulsion, baby might have unresponsiveness, up-rolling of eyeballs, clenching of teeth, frothing from mouth or tightening or jerky movement of limbs.
• Most of these episodes are brief and last for less than 5 minute and stop on their own.
• Most febrile seizures stop by age of 5 years.
• It is not epilepsy and it will not affect brain development and intelligence of child.

Why some children get febrile seizure and other don't?

Well, unfortunately science doesn't have answer to this question yet. It usually occurs when child develops fever because of viral or bacterial infection such as urinary tract infection, ear infection or any flu. 

Seizure occurs due to abnormal increased electrical activity in brain. During febrile seizure, due to rapid rise of temperature. sudden and dysregulated increase in electric discharges in the brain lead to unconsciousness with shaking of limbs.  

Precautions that needs to be taken if child develops fever next time

1. Keep a record of child's temperature. Best is to chart it. 
2. To prevent discomfort to the child, avoid overdressing and put the clothes appropriate for climatic condition.
3. Ensure adequate intake of fluids to prevent dehydration.
4. Tepid sponging should be done if temperature is above 102 degree F.
5. Paracetamol should be administered in the dosage recommended by pediatrician. Paracetamol would help to reduce temperature.
6. Don't substitute paracetamol drops with syrup as concentrations are different. 
7. Clobazam may be administered in selected cases as per recommendations from pediatrician. It increases the threshold of having seizure hence risk is minimized but it can't be completely avoided.
8.  The cause of fever must be identified and appropriately treated. 

What to do if child develops convulsion(seizure)

1. Most important, Don't get frightened when child develops convulsion. I know it is easier said than done.
2. Record the event if possible. This will help your doctor to understand the type of seizure.
3. Child should be placed in a lateral position on floor or safe hard surface.
4. Loose the clothes around the neck to prevent airway obstruction.
5. Don't feed anything including medicine by mouth as child may aspirate the medication.
6. Don't place any metallic object in child's hands or mouth(e.g. spoon) to control convulsion. It will only worsen the situation.
7. Most of the seizures are controlled in 3-5 min but if it doesn't happen then administer midazolam nasal spray in the dosage advised by your pediatrician and take the child to nearest hospital for further management. 

What is the risk of having another episode of seizure?

Around 40% of children with febrile seizure will have a recurrence episode. Probability of having recurrent episodes is higher among those with one or more of the following :

1. Age at the onset before 18 months.
2. Seizure occurs within 1 hour of fever
3. Seizure occurs at a lower temperature.
4. One or more of first degree relatives(parents and siblings) has a history of febrile seizure

Risk of epilepsy in children with a history of febrile seizure

• Risk of epilepsy with simple febrile seizure(if seizure lasts for less than 15 min and it only occurs with fever) is 1% which is same as with general population. Hence there is no additional risk after simple febrile seizure.
• Risk of future epilepsy may increase among those with a complex febrile seizure (if episode of seizure is more than 30 min or jerks involve only one side of body)

Effects on intelligence/performance of children with multiple episodes of febrile seizure

1. Febrile seizure don't affect intelligence or school performance.
2. Studies suggest that those with multiple febrile seizure episodes have comparable intelligence to their siblings who do not have a febrile seizure. :)
3. children with prolonged febrile seizure episodes who are prone to future epilepsy may have mild effects.

Disclaimer:  This post is not a substitute of medical treatment. Please consult to your pediatrician and follow his/her advice. We are just another parents like you. Since our child has got one episode of seizure, this topic is so close to our heart and we thought of writing a post on febrile seizure after doing proper research.