Febrile Seizures

What are Febrile Seizures?

Febrile seizures are convulsions that develop due to a sudden change in body temperature or fever. Also known as focal febrile seizures, these seizures are commonly observed in children between 6 months to 5 years, with 12 months to 18 months being the most common age range.

Febrile seizures are divided into two types, simple and complex febrile seizures. Simple febrile seizures are more common in children, last between 2 minutes to 15 minutes, and do not recur within 24 hours. Complex febrile seizures last between 15 minutes to 30 minutes and occur more than once within 24 hours.

Associated Anatomy

One arm, leg, or one side of the body

Febrile Seizures Causes

Currently, the exact cause behind febrile seizures is yet to be understood. Research studies suggest that they could develop due to the following factors.

• Infection - Bacteria or viruses can trigger the outbreak of fever in children. The influenza virus or the virus that causes Roseola has been suggested to cause febrile seizures
• Immunizations - It is commonly observed that children who take the MMR (Measles, Mumps, Rubella) immunization develop febrile seizures between 8 days to 14 days after the immunization has been given.

Signs or Symptoms of Febrile Seizures

The symptoms of febrile seizures vary based on the two types, simple or complex febrile seizures.

The symptoms of simple febrile seizures are:

• Loss of consciousness or fainting
• High fever of 100.4 ℉
• Full body convulsions or generalized convulsions
• Shaking limbs
• Tiredness or confusion after the episode
• Clenching of teeth or jaw
• Rolling of the eyes

The symptoms of complex febrile seizures are:

• Frequent bouts of fever
• Body temperature is lower in the first seizure
• Twitching of one part or one side of the body
• Lose control of bowel movements

Possible Febrile Seizures Treatment

While febrile seizures do not cause permanent brain damage, one must take the necessary steps to febrile seizures treatment. The doctor will prescribe:

• Fever medication - The doctor will prescribe fever medication such as Ibuprofen or Tylenol to reduce the fever
• Ointment or gel - In the case of recurrent seizures, the doctor will prescribe Valium gel that is administered on the rectum of the child to control the seizures

Risk factors

The following factors may increase the risk of developing febrile seizures.

• Family history - Children with a family history of febrile seizures have a higher risk of developing them
• Age - Since febrile seizures are commonly seen in children between 6 months to 5 years, children fling in this age group have a higher chance of developing them

Possible complications

Febrile seizures do not cause any long-lasting complications relating to the child’s intelligence, social development, or brain damage. However, recurrent episodes of complex febrile seizures may increase the risk of developing epilepsy after the age of 7 years.

Prevention

Primary Prevention

Currently, there is no way to completely prevent a febrile seizure as researchers believe that genetics play a role in the development of febrile seizures.

Secondary Prevention

One can take the following steps when their child is having a febrile seizure.

• Stay calm and roll your child onto the side
• Do not restrain or hold the child down during the seizure
• Do not put anything inside the child’s mouth
• Move sharp and harmful objects away from your child
• Loosen their clothing
• Time the seizure

If it lasts for more than five minutes and your child is not breathing, immediately take the child to the nearby hospital

Alternate Name

Focal febrile seizure

Typical Test

The first step to diagnosing febrile seizures is to ask about the medical history of the child and conduct a physical exam to get a better understanding of the symptoms. Once this is completed, and all other factors of epilepsy are ruled out, the doctor may recommend running the following tests for a clearer diagnosis.

• Blood tests - The doctor may recommend blood tests to check for any sign of bacterial or viral infection
• Spinal tap - This test involves inserting a needle between two lumbar bones to check for signs of meningitis
• Imaging tests - In the case of a complex febrile seizure, the doctor may recommend an Electroencephalogram (EEG) to monitor the brain activity. They may also recommend a Magnetic Resonance Imaging (MRI) scan to check for any abnormalities in the brain

Epidemiology

• Commonly occurs in children between 6 months to 5 years, 12 months to 18 months being the most common age range
• More frequently observed in Asian children with an incidence rate of 5% to 10% in Indian children, 6% to 9% in Japanese children
• Febrile seizures commonly occur during the winter season and the afternoon

Expected Prognosis

Although it can be frightening to see your child having a febrile seizure, fortunately, it does not have a harmful impact on the child’s health. After 6 years of age, the child outgrows febrile seizures and continues to go through normal growth and development. One-third of the children have one recurrent episode of febrile seizure with less than 10% of the children having less than 3 recurrences.

Natural progression

If febrile seizures are left untreated, they may evolve into generalized seizures or increase the risk of developing epilepsy.

Pathophysiology

The development of febrile seizures may be due to genetic factors. Research also indicates that changes in the firing of neurons related to temperature regulation and production of cytokine due to fever or inflammation may result in the development of febrile seizures.