—
This is taken from a book written by Dr. Barton Schmidt and deals with febrile seizures. The 2 big take-home points about seizures, or convulsions, that are induced by fever are these: simple febrile seizures that last less than 30 minutes do NOT harm the child’s brain (YOU may faint, but your child will be fine) and the 4% of children that have febrile seizures are not just any 4% of the population. They are genetically predisposed to febrile (occurring with a fever) seizures. That means that if your child is not in that 4% of the population that is susceptible to them, he or she will not have a seizure no matter how high the fever goes.
If your child is 2 or 3 years old and is having the 5th or 6th high fever of her life, then there is almost no chance that she’s in that 4% and there is no need to worry. One final point: febrile seizures do NOT predispose your child to epilepsy. About 1% of children with febrile seizures will go on and develop epilepsy, which is exactly the same incidence as occurs in the general population, since about 1% of ALL people will one day develop epilepsy.
What are febrile convulsions?
Convulsions are also called seizures. Febrile convulsions are seizures triggered by high fever. They are the most common type of convulsion and are usually harmless. The average body temperature at which they occur is 104°F (40°C). The fever itself can be caused by an infection in any part of the body.
Children who have febrile convulsions are usually 6 months to 5 years old. A child’s first febrile convulsion usually occurs by 3 years of age.
During a convulsion, your child may:
• become stiff
• become unconscious or not know where they are
• have jerking or twitching movements
• have the eyes roll backward
• have noisy breathing
• after the seizure, your child may be sleepy and confused for a while.
How long will the effects last?
Each convulsion usually lasts 1 to 10 minutes without any treatment. Febrile convulsions do not cause any brain damage. However, a few children (3%) will have convulsions without fever sometime in the future.
Febrile convulsions occur in 4% of children. Most of these children have just one febrile convulsion in a lifetime. About one-third of children who have had a febrile convulsion have 1 to 3 recurrences over the next few years. Febrile convulsions usually stop happening by the time a child is 5 or 6 years old.
What should I do when my child has a convulsion?
• Reduce the fever. Bringing your child’s fever down as quickly as possible may shorten the seizure. Remove your child’s clothing and apply cold washcloths to the face and neck. If the seizure persists, sponge the rest of the body with cool water. As the water evaporates, your child’s temperature will fall. When the convulsion is over and your child is awake, give the usual dose of acetaminophen or ibuprofen for your child’s weight and age, and encourage your child to drink cool fluids.
• Protect your child’s airway. If your child has anything visible in the mouth, clear it with a finger to prevent choking. Place your child on the side or stomach (face down) to help drain secretions. If the child vomits, help clear the mouth. Use a suction bulb if available. If your child’s breathing becomes noisy, pull the jaw and chin forward. NEVER put your fingers or a spoon into the mouth of a child who is seizing; your fingers will be bitten off, or the child will shatter his teeth on a metallic object such as a spoon.
Call a rescue squad (911) IMMEDIATELY if the febrile convulsion continues more than 10 minutes.
• Driving to a medical facility. If you are told to drive to a medical facility, dress your child lightly (weather permitting). (Warning: Prolonged seizures due to persistent fever have been caused by bundling up sick infants during a long drive.)
• Common mistakes in first aid of convulsions. During the convulsion, don’t try to restrain your child or stop the seizure movements. Once started, the seizure will run its course no matter what you do. Don’t try to resuscitate your child just because breathing stops momentarily for 5 to 10 seconds. Instead, try to clear the airway. Don’t try to force anything into your child’s mouth. This is unnecessary and can cut the mouth, injure a tooth, cause vomiting, or result in a serious bite of your finger. Don’t try to hold the tongue. Children may rarely bite the tongue during a convulsion, but they can’t swallow the tongue.
How can I take care of my child?
• Oral fever-reducing medicines: Febrile convulsions usually occur during the first day of an illness. Although research is lacking, preventing high fevers may prevent some febrile seizures. Begin acetaminophen (Tylenol) or ibuprofen (Advil) at the first sign of any fever (a temperature over 100°F, or 37.8°C) and give it continuously for the first 48 hours of the illness. Because fever is common after DTaP immunizations, begin acetaminophen or ibuprofen in our office when your child is immunized and continue it for at least 24 hours.
• Fever-reducing suppositories: Have some acetaminophen suppositories on hand in case your child ever has another febrile seizure (same dosage as oral medicine). These suppositories may be kept in a refrigerator at the pharmacy, so you may have to ask for them.
• Light covers or clothing: Avoid covering your child with more than one blanket when they are sick. Bundling during sleep can push the temperature up 1 or 2 extra degrees.
• Lots of fluids: Keep your child well hydrated by offering plenty of fluids.
How can I help prevent convulsions?
The only way to prevent future febrile convulsions completely is for your child to take an anticonvulsant medicine on a daily basis until the age of 3 or 4 years. Because anticonvulsants have side effects and febrile seizures are generally harmless, anticonvulsants are rarely prescribed unless your child has other neurologic problems. We will discuss this decision with you.
When should I call Meyer Pediatrics (365-5898)?
Call us IMMEDIATELY after the seizure is over. If your child has had one or more febrile seizures in the past, you may feel comfortable waiting until the following morning to notify us, but feel free to call us whenever you have questions.
________________________________________
Published by McKesson Provider Technologies.
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Copyright © 2005 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.