Febrile Seizure - Types, Causes, Symptoms, Diagnosis, and Treatment

Introduction:

A febrile seizure is a convulsion caused by a fever in a child. It is a type of epilepsy characterized by recurrent seizures that usually last a few seconds and occur without warning. Febrile seizures are also known as infantile spasms or salaam seizures and are most commonly seen in infants and young children. These seizures are usually brief and painless. Most children with them will recover quickly without long-term consequences or complications. However, 2.5 % and 5 % of children with complex febrile seizures develop epilepsy.

Who Gets Febrile Seizures?

• Febrile seizures typically occur in children between six months and five years, with peak age between 12 and 18 months.

• They are most common in children under three.

• Boys are more likely to experience a febrile seizure than girls.

• There is a genetic component, meaning febrile seizures tend to run in families.

• Children with a previous febrile seizure have an increased risk of having another one.

• A child’s risk of febrile seizures is higher if they have a sibling who has experienced them.

• Febrile seizures are more likely if a child’s temperature rises quickly due to an infection or illness.

What Are the Types of Febrile Seizures?

Febrile seizures are classified into two different types: simple febrile seizures and complex febrile seizures.

• Simple Febrile Seizures - These are the most common type of febrile seizures. These seizures usually last less than 15 minutes and affect only one body part. Common symptoms of a simple febrile seizure include stiffening or jerking movements in the arms or legs or twitching of the face. There is usually no loss of consciousness, and the child does not appear confused after the seizure has stopped.

• Complex Febrile Seizures - These are more serious than simple febrile seizures. These seizures usually last longer than 15 minutes, involve more than one body, and may confuse afterward. Symptoms include twitching arms or legs, losing consciousness, drooling, and incontinence. It is important to note that children experiencing a complex febrile seizure should receive medical attention immediately.

What Are the Main Symptoms of Febrile Seizures?

The three main symptoms of febrile fever are shaking, loss of consciousness, and loss of control.

• Shaking or Convulsing - It is the most common symptom associated with febrile seizures and usually occurs when the patient experiences muscle spasms due to high body temperature.

• Loss of Consciousness - Occurs when the patient becomes unresponsive and does not respond to verbal or physical stimuli. Loss of consciousness happens with or without shaking.

• Loss of Control - It happens when the patient experiences involuntary or uncontrolled movements, such as rolling their eyes, making jerky movements, or having difficulty breathing. These symptoms can happen in a single episode of febrile seizure or in varying combinations throughout several episodes.

What Causes the Febrile Seizures?

High fevers in children cause febrile seizures. They usually occur when a child's body temperature rises to 101 degrees Fahrenheit or higher. This type of fever is most common in children between the ages of six months and five years old, although it can happen to any age group. The main cause of febrile seizures is a rapid rise in body temperature, often caused by a virus or bacterial infection. Other causes can include an adverse reaction to the medication, environmental exposure, or an underlying medical condition such as epilepsy or a brain injury. In addition, infection due to the following diseases can cause fever leading to febrile seizures:

• Chickenpox.

• Ear infections.

• Malaria.

• Influenza.

• Coronavirus (COVID-19).

• Meningitis.

• Strep throat.

• Stomach flu (gastroenteritis).

• Upper respiratory infections

• Tonsillitis.

How to Diagnose Febrile Seizures?

Diagnosis of a febrile seizure typically involves a physical exam and a medical history. First, the doctor will examine the child and ask questions about their symptoms, such as what type of seizure occurred and how long it lasted. The doctor may also order blood tests, urine tests, and a spinal tap to rule out other seizure causes. Sometimes, they may order an EEG (electroencephalogram) or brain imaging, such as an MRI (magnetic resonance imaging) or CT (computed tomography) scan. These tests can help to confirm that a seizure has occurred and help to identify any underlying conditions that may have caused it.

How to Treat Febrile Seizures?

Most febrile seizures stop independently within a few minutes and do not need any specific treatment. The primary aim of treatment is to reduce fever, which can be done with medications such as Ibuprofen or Acetaminophen. However, ensuring that the child stays hydrated and gets plenty of rest is also important. If a seizure lasts longer than five minutes or if there is more than one seizure within 24 hours, the doctor may prescribe anticonvulsant medication such as Diazepam. This medication prevents or reduces the length and intensity of future seizures. It is important to note that anticonvulsant medications are not recommended during the initial febrile seizure as they can cause side effects and may not necessarily benefit. If the child has a febrile seizure, follow these steps:

1. Stay Calm: It is normal for parents to feel panicked during a seizure, but staying calm can help them respond better and take the necessary steps.

2. Protect Child From Harm: Move furniture and other objects away from the child and place them safely on their side or stomach.

3. Monitor Child’s Breathing: Watch for any changes in breathing, including difficulty breathing or pausing.

4. Time of the Seizure: This will help the doctor determine the duration and severity of the seizure.

5. Keep the Child Safe: If possible, turn the child onto their side, loosen any tight clothing, and check their mouth to ensure nothing is blocking their airway.

6. Stay With the Child: Remain close to the child until they become alert and responsive.

7. Call 911 if Needed: Call 911 (local emergency service number) if the seizure lasts longer than five minutes or if the child has multiple seizures without regaining consciousness between them.

Conclusion:

Febrile seizures are a type of seizure that can occur in children, typically between the ages of six months and five years old. These seizures are caused by a rapid increase in body temperature (febrile fever). The main symptoms of febrile seizures include convulsions, loss of consciousness, and uncontrolled body movements. If a child experiences any of these symptoms, they should be seen by a medical professional as soon as possible. Treatment of febrile seizures typically involves managing the fever with medication and providing supportive care. Further testing may be required to rule out any underlying conditions in some cases. However, with proper diagnosis and treatment, children who experience febrile seizures can usually fully recover.