Summary about Disease
Febrile seizures are convulsions triggered by a fever in infants and children, typically between the ages of 6 months and 5 years. They are generally harmless and do not cause long-term health problems. There are two main types: simple febrile seizures, which are brief and generalized, and complex febrile seizures, which are longer, focal (affecting one side of the body), or occur more than once within 24 hours.
Symptoms
Loss of consciousness
Shaking or jerking movements of the arms and legs
Stiffening of the body
Eye rolling
Foaming at the mouth
Urinary or bowel incontinence
The seizure is always associated with a fever (temperature of 100.4°F (38°C) or higher).
Causes
Febrile seizures are caused by a fever, often due to a viral infection (e.g., cold, flu, roseola) or, less commonly, a bacterial infection. The exact mechanism by which fever triggers seizures is not fully understood, but genetic factors may also play a role. Rapid changes in body temperature seem to be more likely to trigger a seizure than the absolute height of the fever.
Medicine Used
Fever Reducers: Medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are used to reduce the fever. It is important to note that fever reducers do not prevent febrile seizures, and their use is primarily for comfort.
Anti-seizure Medications: Usually not necessary for simple febrile seizures. In rare cases of prolonged or recurrent complex febrile seizures, a doctor may prescribe a short-acting anti-seizure medication, such as rectal diazepam or lorazepam, to be administered during a seizure. Daily anti-epileptic medication is generally not recommended after febrile seizures.
Is Communicable
Febrile seizures themselves are not communicable. However, the underlying infection causing the fever may be communicable (e.g., a viral cold).
Precautions
During a seizure:
Stay calm.
Place the child on their side to prevent choking.
Remove any sharp or hard objects from the area.
Do not put anything in the child's mouth.
Loosen tight clothing.
Time the seizure.
After a seizure: Seek medical attention to determine the cause of the fever.
Keep the child comfortable and hydrated.
Follow the doctor's recommendations for managing fever.
How long does an outbreak last?
A febrile seizure is a single event related to a specific fever. There isn't an "outbreak" in the traditional sense of a communicable disease. The seizure lasts for a few seconds to (typically) less than 15 minutes. The underlying fever may last for several days, depending on the cause.
How is it diagnosed?
Diagnosis is based on:
Clinical history: The child's age, seizure description, and presence of fever.
Physical examination: To identify the source of the fever.
Neurological examination: To assess the child's neurological function.
Further tests: Blood tests, urine tests, or cerebrospinal fluid (CSF) analysis (lumbar puncture) may be performed to identify the cause of the fever, especially if meningitis is suspected. An EEG (electroencephalogram) is usually not necessary after a simple febrile seizure, but may be performed if the seizure is complex or if there is concern about epilepsy. Brain imaging is almost never performed.
Timeline of Symptoms
1. Initial illness: The child develops symptoms of an infection (e.g., runny nose, cough, earache), often preceding the fever. 2. Fever onset: The child's temperature rises to 100.4°F (38°C) or higher. 3. Seizure: The seizure occurs, typically lasting for a few seconds to less than 15 minutes. 4. Post-ictal phase: After the seizure, the child may be drowsy, confused, or irritable for a short period. 5. Fever resolution: The fever gradually subsides over several days as the underlying infection resolves.
Important Considerations
Most febrile seizures are harmless and do not cause brain damage, epilepsy, learning problems, or death.
There is a slightly increased risk of epilepsy (seizure disorder) after a complex febrile seizure or if there is a family history of epilepsy.
Parents should be educated about what to do during a seizure and when to seek medical attention.
Recurrence is common: approximately one-third of children who have one febrile seizure will have another.
Vaccination is safe: Vaccines do not cause febrile seizures. Fever following vaccination can trigger a seizure in susceptible children, but the risk is small and the benefits of vaccination far outweigh the risks.