Prognosis
Febrile convulsions are common in small children. They stop after a few minutes and do not leave any permanent damage to the child. The prognosis is therefore very good, because even if the child turns blue for a short time, the brain is supplied with sufficient oxygen and is not damaged.
The child’s mental and motor development is normal even after repeated simple febrile convulsions. In about 30% of cases, one or more further febrile convulsions may occur, which is why early fever reduction is recommended from 38.5°C body temperature. It is important for parents to know that a child does not have an increased risk of developing epilepsy later in life due to the febrile convulsion. The overall risk is 2-4%, which is no different from the probability of epilepsy in the general population. However, the risk of developing epilepsy is significantly higher (about 10%) in children who have a complicated febrile convulsion or family members with epilepsy.
Prevention/Prophylaxis
Many parents ask themselves what can be done prophylactically against the occurrence of febrile convulsions.Since a rapid rise in body temperature can often trigger febrile convulsions, many parents assume that the use of antipyretic drugs (e.g. paracetamol) can have a preventive effect. International clinical studies cannot provide evidence for this and show that effective prevention is not possible. Accordingly, antipyretic drugs should not be used to prevent new attacks, but only to relieve the symptoms caused by the fever.
Also classical home remedies such as calf or belly compresses are helpful to reduce the increased body temperature. As always with fever, it is important to make sure that the child takes in enough fluids. To counteract a renewed febrile spasm you can use an anti-convulsant called diazepam.
This can be given to the child if a fever recurs and the muscle cramps do not go away after a few minutes of observation. The actual benefit is still controversial, but it is thought to have a preventive effect. When using these drugs, however, one must also consider the numerous side effects such as confusion, nausea and easy excitability.
Therefore, routine prophylaxis should not be done in all infants who have had febrile convulsions. If the child has already had the 3rd febrile convulsion or if other aggravating factors are present (complex febrile convulsion), it may still be necessary for the pediatrician to prescribe the antispasmodic drug for administration at regular intervals over a longer period of time.
