Sunday, July 10, 2011

Febrile seizure? Time to cool off your child

What is a Febrile Seizure:

Febrile seizures, or commonly know as fever fits, are common. Up to 4 % of children throw fits during a febrile episode. Febrile seizures are commonly seen in age group 6 months to 6 years of age. It is a very frightening experience for any parent to witness his little one seizing. But most febrile seizures are harmless.

Febrile seizure is not same as epilepsy. Epilepsy [Seizure disorder, also called as Mirgi or Apasmar in India] is repeated seizures, that are unrelated to fever. Epilepsy is treatable, though it requires medications for a prolonged duration.

The exact cause for fever fits is unknown, but they are known to run in families. Fever is usually triggered by any infection like common cold or a diarrhea, and the child can throw a seizure at the height of fever. This seizure is usually self limiting, subsides within a few seconds/ minutes [usually less than 10 min] and child regains consciousness soon after.


Do these seizures tend to recur?

In up to 30-50% chances, these seizures may recur with fever. A positive family history, younger age [less than a year] makes a child prone for recurrent febrile seizure. Usually children out grow their febrile seizure by the age of 5-6 years. In rare instances, if there are more than one febrile seizure in a day, or the fits occur only in some one part of the body, there is a risk of developing epilepsy.

Do they have any effect on child's brain?

In most instances, these febrile seizures last for a few seconds, do not recur within 24hrs. Such simple febrile seizures are benign in nature, and these children do not develop epilepsy or have any long term effects on their brain development.

What is meningitis?

Meningitis is a serious condition. Its the infection of brain and its surroundings. Meningitis can also present with fever and seizures, just like febrile seizure, but children with meningitis are usually sicker and have other symptoms like poor feeding, lethargy and vomiting.
In case of fever and seizure you need to rush hospital immediately if:
  • Your child is less than 6 months of age
  • Not feeding properly
  • Excessively sleepy
  • Headache/ neck pain
  • Purple rash anywhere on the skin
  • first time fever with seizure


What is the treatment for febrile seizure?

Before starting treatment, many a times treating physicians may have to perform certain blood tests and lumbar puncture to confirm that the child is not suffering from meningitis, as both conditions can present in similar fashion. Lumbar puncture, when performed under expert hands, is a safe procedure, and does not have any effect on child's spine/ walking.

Febrile seizure usually does not need any extra treatment other that control of fever. An anti-seizure medication [eg. Frisium] may be prescribed for a short duration of 3-5 days, but there is usually no need for long term anti-seizure medications. Antibiotics are usually given if the cause of fever is bacterial throat/ ear/ urinary infection.

What the parents can do at home:


In a known case of febrile seizure, parents can start with fever medications as soon as the child gets a fever anytime above 100.4*F [38*C]. The temperature can be measured in the armpit and not necessarily in the mouth. One should avoid using the mercury thermometer in mouth as there is risk of biting & breaking the thermometer. It is a good idea to have a prescription of paracetamol [same as Crocin / Calpol/ PCM] with the dosage written from your pediatrician. Paracetamol is a safe drug and can be safely given up to 4-5 times in a day for the control of fever. Various drugs like Aspirin/ Nimesulide are harmful in children, and are best avoided. Wet sponging the whole body [not just forehead] is sometimes helpful in bringing down the fever, if its too high.

Despite adequate control of fever, child may throw a seizure. In such case, place the child on a safe place to avoid injury. Remove any tight clothing/ jewelery around the neck and place the child in lateral position. Make sure the airway is open, do not splash water on face [a common but dangerous custom in India]. A rectal suppository [soft tablet to be inserted in to the anus] or nasal spray of anti-seizure medications are available on prescription, and can be used during such episode to control the seizures. Consult your pediatrician and keep this medications handy, stored in refrigerator. After the fits have subsided, do not immediately feed the child.

Always visit your pediatrician after any episode of fever with seizure to make sure it isn't something other than a febrile seizure.