Febrile seizures in children

SEIZURES are one of those illnesses that parents hope they never have to deal with in their children. But unfortunately, with fevers so common in children, Dr Anona Griffith, paediatrician at Gateway Plaza, Old Harbour, says that high temperatures could easily signal febrile seizures. “Febrile seizures are fits or convulsions that occur in the presence of a fever or elevated temperature. It typically occurs in small children three months to six years, especially between 12 and 18 months,” Dr Griffith said.She said that febrile seizures are characterised by:• Fever of more than 100.4 degrees Fahrenheit or 38 degrees Celsius• Jerking, stiffening or a combination of both movements of the body.• The entire body may be involved (generalised) or just a portion (focal).• The seizure usually lasts less than 15 minutes. If greater than 15 minutes, it becomes a complex episode.• There may be a brief period of drowsiness or altered consciousness (postictal phase) after the episode.• Absence of brain or nervous system infection or inflammation (meningitis or encephalitis)• The absence of brain or nervous system disease or abnormal development at the time of the episode.Febrile seizures are divided into three major types – namely: simple, which has all the characteristics previously outlined; complex seizures, with a longer duration or increase in number of seizures; and symptomatic, which are somewhat paradoxical based on the definition, because this group takes into consideration intercurrent illness, and previously existing brain and nervous system abnormalities.The diagnosis of febrile seizures, however, must be reconsidered if fits occur without a fever and the characteristics fall outside of the above.The cause of febrile seizures, Dr Griffith explained, could be any number of things, and the source can be established with a medical investigation.“There is thought to be a genetic component to the condition as it is often seen in families, so there is a possibility there is some link here. You also want to identify the underlying cause of the fever; this is very important so that the underlying condition can be treated. Therefore, history and examination will assist in identifying the cause and so these investigations will be guided by the possible diagnosis,” Dr Griffith advised.Part of the investigative process, Dr Griffith said, especially in children under two, may include a lumbar puncture.“The age group at which the condition is more commonly found provides a challenge on deciding if there is an infection of the brain tissue. In an infant less than two years old, a lumbar puncture to rule out brain infection may be necessary. Any brain infection is a serious condition that must be treated promptly, as it can result in death or significant disability if not [treated],” Dr Griffith warned.She emphasised the importance of managing fevers in children in an effort to control seizures. This can be achieved at home by doing a combination of the following:• Have a functional, user-friendly thermometer. Your hands are not accurate in telling temperatures, though they may be helpful.•Once a fever is identified, appropriate fever-reducing actions can be taken. Medication such as paracetamol can be administered at the appropriate dosage and frequency (not DPH or a cough and fever combination medication).•Sponging with room temperature water (Avoid alcohol or any such containing liquid).•Fan therapy after removing clothing.However, she cautions parents against relying too much on home remedies when the condition can no longer be managed at home. She said medical attention must be sought if the child displays any of the following:• The seizure lasts for more than 15 minutes.• If there are multiple episodes.• There is a prolonged period of loss or alteration of consciousness.Dr Griffith said that febrile seizures can recur, but usually stop after age six. She recommends routine monitoring following the initial episode.