In conjunction with a high fever, a febrile convulsion can occur, especially in young children. A febrile convulsion is accompanied by symptoms similar to those of an epileptic seizure and can lead to unconsciousness in affected children. In most cases, febrile convulsions are harmless.
What is a febrile seizure?
A febrile convulsion usually occurs in conjunction with a high fever. It affects about four percent of young children. Febrile convulsions are most common between the ages of five months and five years. The cause of the fever is not important for the occurrence of a convulsion and can be quite harmless. In a febrile convulsion, symptoms similar to those of an epileptic seizure occur. The body stiffens, in addition to the cramping of arms and legs, the eyes are twisted and the child loses consciousness. The causes for the occurrence of febrile seizures are not yet clearly understood. However, there appears to be a congenital predisposition to the seizures. Febrile convulsions often occur with sudden onset and rapid rise of fever. In principle, however, febrile convulsions can begin at any stage of fever.
Causes
The causes for the occurrence of a febrile convulsion have not yet been fully researched by the medical community. However, it is believed that a febrile convulsion may result from a defensive reaction of the body. Certain defense cells secrete messenger substances during illness, which lead to fever. At the same time, they also cause a change in metabolism in the brain for a short time. This metabolic change can cause a febrile convulsion. There seems to be a hereditary predisposition for the occurrence of the convulsions. Some children also get febrile convulsions after the combination vaccination against measles, mumps and rubella. Nevertheless, children with a tendency to febrile convulsions should also receive this vaccination, because the vaccination is far less likely to cause a febrile convulsion than the diseases themselves. Serious illnesses, such as meningitis, can also cause a febrile convulsion.
Symptoms, complaints and signs
Depending on whether the condition is a simple or complicated febrile seizure, a number of different symptoms may occur. A simple febrile seizure is usually uncomplicated. Typical signs include muscle twitching, rolled eyes and circulatory problems. In a severe course, the initial racing heart and dizziness attacks can develop into circulatory shock, which in most cases leads to unconsciousness in the affected child. Affected children usually appear sleepy and tired, often giving the impression of being in a stupor. A simple seizure can occur over the entire body and usually lasts only a few seconds to minutes. A complicated febrile seizure is manifested by twitching and convulsions that are usually localized. It often lasts for several minutes and places enormous stress on the affected children. Complicated febrile convulsions usually occur several times a day and cause fatigue, exhaustion and confusion in the affected person. This is accompanied by the typical fever symptoms: sweating, cardiovascular complaints and a strong feeling of illness. Serious complications cannot be ruled out either. For example, some patients suffer from panic attacks and anxiety.
Diagnosis and course
In a febrile seizure, the doctor makes his or her diagnosis primarily based on the child’s medical history and the symptoms observed by the parents during the seizure. Usually, a febrile convulsion lasts less than 10 minutes and is not dangerous. For longer-lasting, complicated seizures, the child’s brain activity is examined by an EEG. If the examination is performed directly during a seizure, the values in the EGG are altered and show the typical values of a seizure affecting the whole body. After a harmless febrile seizure, however, all values are normal again. If the readings change after the seizure or the seizure lasts longer than 10 minutes, it is advisable to clarify the causes, as serious illnesses such as meningitis can also cause a febrile seizure. In 90 percent of cases, however, a febrile convulsion takes a harmless course.
Complications
Febrile convulsions usually progress without serious complications. Of concern are febrile convulsions that last longer than ten to fifteen minutes.It may be due to a dangerous infection or poisoning, which in the course of time can cause speech disorders or paralysis, among other things. If the symptoms are caused by meningitis, severe brain disorders, organ diseases and finally organ failure and death of the patient may occur. In one to three percent of all affected individuals, a febrile seizure can cause epilepsy. Rarely, HHE syndrome with hemiparesis and epileptic reactions may also occur. In addition, as a result of the epilepsy or the seizures themselves, the risk of accidents increases. In infants and young children, febrile convulsions are associated with increasing dehydration and various deficiencies that can lead to severe physical and mental disorders. If left untreated, complicated febrile seizures can lead to serious health complications. If treated in a timely manner, prescribed medications carry certain risks. For example, anticonvulsant drugs can cause side effects such as skin rashes, drop in blood pressure, water retention and constipation. In allergic patients, there is a risk of allergic shock. A febrile convulsion should always be clarified by a doctor because of the possible complications.
When should you go to the doctor?
In the worst case, a febrile convulsion can lead to the death of the affected person and for this reason should always be examined by a doctor. Especially in children, these convulsions can be very dangerous and usually require medical treatment. The doctor should be consulted if the affected person suffers from high fever and cramps in the muscles. Various muscles may be affected, so that ordinary movement of the affected person is often not possible. If the affected person loses consciousness due to the febrile convulsion, an emergency doctor must be called or the hospital must be visited. Until the emergency physician arrives, the patient must be placed in a stable lateral position and may need emergency ventilation. Eye-rolling may also indicate a febrile convulsion and should be investigated. Often, these convulsions last only a few minutes and are not dangerous. A visit to the doctor is necessary if the convulsions last longer than ten minutes and occur more frequently. Treatment can be given in a hospital or by a general practitioner or pediatrician. In most cases, a positive course of the disease is achieved by taking medication.
Treatment and therapy
In most cases, febrile seizure ends on its own without treatment. Then therapy consists of reducing the fever by antipyretic agents Febrile convulsions usually pass without serious complications. Febrile convulsions that last longer than ten to fifteen minutes are a cause for concern. They may be caused by a dangerous infection or poisoning, which can lead to speech disorders or paralysis. If meningitis is the cause of the symptoms, severe brain disorders, organ diseases and finally organ failure and death of the patient can occur. In one to three percent of all affected individuals, a febrile seizure can cause epilepsy. Rarely, HHE syndrome with hemiparesis and epileptic reactions may also occur. In addition, as a result of the epilepsy or the seizures themselves, the risk of accidents increases. In infants and young children, febrile convulsions are associated with increasing dehydration and various deficiencies that can lead to severe physical and mental disorders. If left untreated, complicated febrile seizures can lead to serious health complications. If treated in a timely manner, prescribed medications carry certain risks. For example, anticonvulsant drugs can cause side effects such as skin rashes, drop in blood pressure, water retention and constipation. In allergic patients, there is a risk of allergic shock. A febrile convulsion should always be clarified by a doctor because of the possible complications. In the case of an existing febrile convulsion, the first priority should be to ensure that the convulsing child cannot injure himself. If the febrile convulsion lasts longer than two minutes, anticonvulsants such as diazepam can be given. If the convulsion lasts longer, the emergency physician should be called. In children who suffer from febrile convulsions more frequently, seizure prophylaxis should be given to reduce the risk of another febrile convulsion. As a rule, these children receive an anticonvulsant medication for every illness that is accompanied by fever.This can prevent a febrile seizure from occurring again in most cases.
Outlook and prognosis
Because the cause of a febrile convulsion is dehydration and, as a result, spontaneous discharge of cerebral neurons, the fear of developing epilepsy is well-founded, as spontaneous discharge also occurs in the brain. However, the prognosis after a febrile seizure is good. Only one in three children may suffer further febrile convulsions in the course of their infantile life, since the reaction in the brain to temperature elevation is a complex and unalterable pattern during certain developmental processes. It is imperative that every febrile convulsion be evaluated by a medical professional, since not only the cause, such as meningitis, but also complications, such as a laceration, must be clarified and treated if necessary. Only about one in 100 children who suffer a febrile seizure will develop epilepsy later in life. However, important influencing factors play a decisive role here. Febrile convulsions in infants, epilepsy in the immediate family and a generally conspicuous mental development are criteria that can favor the development of epilepsy. In general, febrile seizures cannot be prevented, but it is advisable to tolerate temperature rises only up to 38.5 degrees Celsius and then treat them. This can minimize the risk in many cases. Prophylactic administration of anticonvulsant drugs is not advisable because the side effects are not proportional to the benefits.
Prevention
Preventive measures against the occurrence of a febrile convulsion should always be taken if there is an increased risk. This may be the case if the child has had a febrile convulsion before. However, preventive measures should also be considered if febrile convulsions have occurred in the family. In these cases, any fever that occurs should be treated immediately with antipyretic medication. In children, this is usually done with the help of fever suppositories. An antiepileptic drug can also be administered prophylactically, thus preventing febrile convulsions in febrile illnesses.
Follow-up
First and foremost, a febrile seizure must be treated immediately by a physician. If left untreated, it can lead to severe complications or other ailments and usually worsen, so the focus is always on early detection and treatment of this condition. In the worst case, this can even lead to the death of the affected person if the febrile seizure is ignored and not treated. As a rule, the aftercare measures always depend on the treatment of the underlying disease that is responsible for the febrile seizure. Especially in children, immediate treatment by a physician is necessary. The treatment itself is carried out with the help of drugs that can reduce fever. These medications should be taken according to the doctor’s instructions in order to relieve the symptoms. If the febrile seizure still persists after a few days, a doctor must be consulted again in any case. If the symptoms are severe, the patient may be taken directly to hospital or an emergency doctor may be called. In general, the person affected by a febrile convulsion should rest and take care of his body.
What you can do yourself
If a febrile seizure occurs for the first time, the emergency physician should be called. Most of the time, however, the symptoms subside on their own. It is important to protect the affected person from injury (e.g., from sharp edges or corners) and to reassure him or her if possible. If the affected person vomits, he or she must be placed in the recovery position. In less severe cases, gentle elevation on the bed or a soft blanket is sufficient. It is also best to loosen clothing and cool the body with calf wraps. Children may be given a fever suppository (acetaminophen or ibuprofen) if they have a febrile convulsion. Adults may take fever-reducing medications. During the initial convulsion, attention should also be paid to serious symptoms and help should be sought if necessary. Usually, however, the febrile convulsion resolves within a few minutes. After the febrile convulsion, the following applies: measure the body temperature at intervals of two to three hours and watch out for the first signs of a renewed convulsion. The affected person should also drink plenty of water and take it easy. After the recovery phase, a doctor should be consulted.If febrile convulsions occur regularly, the physician may prescribe an anticonvulsant as a precautionary measure, which can be used in an emergency.