Febrile convulsion in children refers to seizures which are the most common type of seizures observed in the paediatric age group. Febrile convulsion is a form of convulsion described as sudden, violent, irregular movement of the body, caused by involuntary contraction of muscles due to a rise in body temperature. Febrile convulsion in children occurs from the period of 6 months to 5 years. The diagnosis requires excluding other causes of convulsion within the central nervous system .
Children who have a febrile seizure are at risk of having recurrent episodes; the recurrence rate is approximately 30 to 35 percent, hence the need to educate mothers on home remedies for fever before presenting at the hospital.
What Causes Febrile Convulsion in children?
No one knows why febrile seizures happen. But evidence suggests that it’s linked to the way a child’s developing brain reacts to high fever. Febrile seizures occur in young children at a time in their development when the seizure threshold is low. This is a time when they are susceptible to repeated childhood infections and the most common presentation is fever. Various diseases that can cause febrile convulsion include;
- Parasitic infection; such as Malaria
- Bacterial infection such as Shigella and Campylobacter bacteria, which cause gastroenteritis (e.g., diarrhoea, nausea, vomiting, fever)
- Viral infections such as measles
- Upper and Lower respiratory tract infections such as pneumonia, tonsillitis , pharyngitis.
- Urinary tract infections , osteomyelitis etc
SIGNS AND SYMPTOMS OF FEBRILE CONVULSION
The symptoms of febrile convulsion include;
- Fever (always present)
- Loss of consciousness (usually less than 30 minutes).
- Muscle stiffness or jerking.
- Upward rolling of the eyes.
The convulsion may last for several minutes. When the movements stop, the child will regain consciousness but will probably remain sleepy or irritated afterwards.
TYPES OF FEBRILE CONVULSION
Febrile convulsion can be classified as;
- simple febrile convulsion
- Complex febrile convulsion
Simple febrile convulsion usually lasts less than 15 minutes, and affects the whole body with no repeat episode of convulsion while complex febrile convulsion affects just a part of the body, lasts for more than 15 minutes and multiple seizures can occur in close concession.
There is no specific test for diagnosis of convulsion and the diagnosis is symptomatic. It is important to identify the underlying disease causing the fever and ensure appropriate treatment.
WHAT TO DO IF A CHILD CONVULSES
When a child is having a fit,
- Basic first aid should be given by the caregiver before presenting at the hospital.
- It is important you remove all dangerous structures around the child when the child is convulsing.
- If you can, roll your child gently on his side or roll his head to the side so that any fluids can drain out of his mouth. This also helps the tongue to fall to the side away from the teeth.
- Try to put something soft like a folded jacket under your child’s head. Remove any tight clothing, especially around your child’s neck. Remove glasses so they do not break.
- Do NOT try to put anything in your child’s mouth. This could cause choking or broken teeth which can be aspirated into the lungs and cause choking.
- Your child’s doctor will want to know how long the seizure lasts. If you can, look at a clock or your watch to see when the seizure starts and ends.
- Take your child once the seizure aborts to the hospital where the history of previous infection is taken. Doctors in the hospital can conduct tests and give treatment.
- Try to stay calm
HOW TO PREVENT CONVULSION IN CHILDREN
- Get a thermometer and learn how to use it
- If you notice fever ensure you reduce the number of clothing of the child
- Tepid sponge with lukewarm water (not cold or hot water) the child to reduce fever
- Give paracetamol to help reduce the fever
- Visit the hospital for appropriate diagnosis
RISK OF RECURRENCE
The risk of recurrent febrile seizures is higher for children who:
- Are young (less than 15 months)
- Experience frequent fevers
- Have a parent or sibling who had febrile seizures or epilepsy
- Have a short time between the onset of fever and the seizure
- Had a low degree of fever before their seizure
Note that febrile convulsion usually doesn’t lead to brain damage and having a febrile seizure does not mean that a child has epilepsy; epilepsy involves having recurrent seizures in the absence of fever.