Febrile seizures in children. How to treat?

What are febrile seizures in children? Does the child have epilepsy? What treatment is needed and what is the prognosis for the future?

Febrile seizures are convulsions in a child, usually caused by a temperature jump due to a viral illness. Moreover, the temperature of the baby does not have to be high in order to provoke them.

This is a fairly common phenomenon that occurs in 4 out of 100 children.

Febrile seizures in a child are a tragic sight for every parent, especially when they occur for the first time and parents do not know what exactly is happening to their child.

Such convulsions in a child at a temperature, most often occur between the ages of one month and up to 5 years. There is a small group of children in whom seizures can continue until a later age – up to 10 years.

Are febrile seizures in children epileptic seizures ?

Febrile seizures are epileptic seizures, but on the other hand, children are not considered to have epilepsy.

Will febrile seizures recur in the future?

One in three children who have had febrile seizures will have them again at a later age. In addition, there is a high risk of recurrence of convulsions in those children in whom relatives in the first line suffered from this type of seizures or those who often suffer from acute respiratory viral infections with fever.

What is the chance of a child developing epilepsy after a febrile seizure in childhood?

In children with simple febrile seizures, the chance of developing epilepsy in the future is quite low and amounts to 1%, as in absolutely healthy children.

On the other hand, in children with complex febrile seizures, the chance of developing epilepsy is higher – one in 6 children will suffer from epilepsy of some kind in the future.

An association between patients with temporal lobe epilepsy and febrile convulsions in childhood has been proven. Many patients diagnosed with temporal lobe epilepsy experienced febrile convulsions in childhood.

There is another group of small patients that belongs to a special genetic syndrome called GEFS+ (generalized epilepsy with febrile seizures). This syndrome is characterized by numerous convulsions in a child at a temperature, and generalized seizures of various types can continue in a child until adolescence.

How to recognize seizures in a child with a temperature?

Febrile seizures are manifested by uncontrolled rhythmic twitches in the limbs. In most cases, seizures due to fever last for a few minutes and resolve without any complications. They also do not require medical intervention or call an ambulance.

The most common types of seizures are:

• Generalized tonic – sharp and prolonged muscle contractions, in which the body freezes in a forced position, and then relaxes. In this case, the child’s back arches, he may cry out, or he may experience involuntary urination.
• Generalized tonic-clonic – consists of 2 phases. During the first phase, the body tenses up, a tonic attack occurs, as described above. In the second phase, the muscles begin to contract, twitches are observed throughout the body. In this case, the child may experience frequent eye twitching or increased salivation.

Simple and complex febrile seizures

According to the classification, febrile convulsions are divided into 2 types:

• Simple – these convulsions at a temperature last a few minutes, are not dangerous to health and do not require urgent medical attention.
• Complicated – last longer than 15 minutes, recur within 24 hours after the first attack, or are focal in nature, when only half of the body is involved in the attack, begins with a blackout, or there is a turn of the head or eyes to the side.

Complicated convulsions are hazardous to health, as they can drag on and turn into status epilepticus (an attack lasting more than 30 minutes), which is extremely dangerous for the patient’s health and can lead to irreversible consequences in the brain, up to death.

Treatment of febrile seizures in children

If convulsions in a child at a temperature occurred once, then treatment is not required. However, prophylactic treatment is recommended to begin after the onset of at least 2 complex febrile seizures.

There is a certain list of antiepileptic drugs that show the most effective results: Phenobarbital, Depakine ( valproic acid), benzodiazepines, and others.