CONVULSION, FEBRILE |
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DESCRIPTIONA febrile convulsion is a seizure triggered by fever and characterized by altered consciousness and uncontrolled muscle spasms. The central nervous system and the musculo-skeletal system are involved. Febrile convulsions usually affect infants and children (ages 6 months to 4 years).
Appropriate health care includes:
Physician's diagnosis and treatment of the underlying cause and monitoring of general condition and medications.
Home care after the seizure has subsided and after diagnosis.
SIGNS & SYMPTOMS
An infection with fever usually precedes the convulsions, but sometimes convulsions may be the first sign of fever. Symptoms include:
Unconsciousness.
Jerking or twitching of the child's arms, legs, or face that lasts 2 to 3 minutes.
Loss of bladder or bowel control.
Irritability upon regaining consciousness, followed by sleep for several hours.
CAUSES
Sudden high fever from any cause, plus an unexplained irritability of the central nervous system in some children.
RISK FACTORS
Repeated infections.
PREVENTING COMPLICATIONS OR RECURRENCEWhen fever begins in a child who has had a febrile convulsion in the past, immediately begin measures to reduce the fever (See HOME CARE).
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies of blood and spinal fluid.
EEG (See Glossary).
POSSIBLE COMPLICATIONS
Body injury during seizure.
Brain injury with repeated seizures.
PROBABLE OUTCOME
Despite its frightening appearance, a convulsion caused solely by fever in a child between 6 months and 4 years of age is usually not serious.
If the first convulsion occurs with fever in a child older than 4, it is probably caused by the fever. However, other causes should be investigated.
If the first convulsion with fever occurs in a child younger than 6 months, a neurological examination and other studies may be necessary.
TREATMENT
HOME CARE
During the convulsion, place the child on his side or turn his head to the side, and move potentially dangerous objects away.
Write down details of the child's convulsion and report them to your doctor. Information should include the following:
-- When did it begin?
-- How soon did the seizure occur after the child's fever rose?
-- Were the limb movements equal on both sides or was one side twitching more than the other?
-- How long did the child's seizure last?
-- Did the child sleep afterward? If so, how long?
The answers will help your doctor decide whether the child's seizure was a febrile convulsion or an epileptic seizure triggered by fever.
After the convulsion, try to reduce fever. See How to Reduce Your Child's Fever, Appendix 17.
MEDICATION
Your doctor may prescribe anti-convulsant drugs, such as phenobarbital, to prevent a recurrence of seizures. Some doctors recommend medication after the first convulsion; others wait to see if convulsions recur. Anti-convulsant drugs are effective only if taken daily during the susceptible years (up to age 4).
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Keep the child resting quietly in bed until fever and the underlying illness are gone. Then allow activity to return gradually to normal.
DIET & FLUIDS
After the seizure ends, encourage the child to drink extra liquids, including water, tea, cola, and fruit juice.
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has a seizure with fever. Call your doctor immediately.
An injury occurs during a seizure.
The underlying illness does not improve in 3 days.
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