About febrile seizures

The term “febrile seizure” used in common speech is principally incorrect. It should better be called a “convulsion during a febrile infection”. This also better expresses the origin of the phenomenon. Because, contrary to beliefs, it is not caused by high fever. It can occur even without a fever, most often occurring at the beginning of the infection, when the fever is just starting, rising.

For those who are not familiar with it, it looks scary.

But let's look at it step by step.

 

Occurrence

Febrile seizure is not uncommon in the first years of life. It occurs in about 3% of children between the ages of half and five, as the child's brain is more sensitive to infections and fever than later. The so-called seizure threshold is lower in childhood. Once a child has had a seizure, it may recur 1-2x in one third of the children until they grow out of it by school age.

No epilepsy will result from a febrile seizure, you don't have to worry about that! Of 100 young children with febrile convulsions, only in two cases is this the first, early sign of a later epileptic illness.

Febrile convulsions do not cause permanent brain damage, nor do they cause behavioral, learning, or developmental disorders.

There is also no link between febrile seizures and sudden infant death syndrome (SIDS).

 

Symptoms of what is called “uncomplicated,” i.e., simple febrile seizures

  • rhythmic twitching of the limbs on both sides,
  • stiffening of the whole body,
  • spasm of less than 5 minutes,
  • usually releases on its own in 1-2 minutes,
  • the patient often falls asleep afterwards,
  • age of child 6 month-5 years.

 

What NOT to do

1) DO NOT add antipyretic medication as an attempt to prevent it. It cannot prevent or eliminate cramps. Not even in a child who has had a febrile seizure before.

2) Do not cool the child for prevention or during a convulsions.

3) In case of convulsions, do not give the child antipyretic medicine, especially not in the mouth.

4) In case of convulsions, do not hold the child down, reach into his/her mouth, do not put anything in it.

 

What can we do?

This can be done to prevent febrile seizures

  1. Let's support the child's thermoregulation! When the fever rises, the child's hands and feet are still cold, in which case it is worth to warm the child gently, instead of cooling. This has been by now scientifically substantiated. This is because heating is an effective preventive method by also raising melatonin levels (132, 170-172). Providing a darkened room and calm to the child in a feverish state also serves this preventive purpose.
  2. It is important to provide the child with calm, comfortable surroundings. This means: avoiding stress, tension, fear, unnecessary stimuli (avoid digital media, as the nervous system requires calm).
  3. When the child's skin heats up in the second phase of the fever, his face is flushed, we can already cool his forehead, temples and body with lukewarm wet washcloths and washing.

In the case of febrile seizures, this can be done

  • the first is to look briefly at the clock as to when it began;
  • keep calm;
  • a stable side position is best, because the child may vomit, swallow, protect hi/her head and airways specifically;
  • stay with the child, watch the clock to determine how long it lasts;
  • call an emergency doctor or ambulance if it occurs for the first time for this child or if the seizure lasts longer than 5 minutes.

 

The complicated febrile seizure

A seizure is considered complicated if

  • seizure phenomena are asymmetric,
  • lasting more than 5 minutes,
  • the symptoms start on one side or start at a certain place of the body (focus),
  • if the child's state of consciousness does not clear between two consecutive seizures,
  • if reoccurs within 24 hours,
  • causes residual nervous system symptoms (sensation, movement),
  • It occurs under the age of 6 month or over 5 years.

 

What to do in case of a complicated seizure

  • If the seizure does not end within 5 minutes, call the emergency number (in Hungary 104) and follow their advice.
  • If we have Diazepam Desitin Rectiole on hand, administer it to the child.

 

Refer to the literature by numbers in this document here: References

Version update: 03 October 2020