CONVULSION, FEBRILE

General Information

DEFINITION--A seizure triggered by rapid rise in temperature and characterized by altered consciousness and uncontrolled muscle spasms.

BODY PARTS INVOLVED--Central nervous system; musculoskeletal system.

SEX OR AGE MOST AFFECTED--Infants and children.

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 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 INCREASES WITH

• Repeated infections.
• A sister or brother who suffered febrile convulsions.

HOW TO PREVENT--When fever begins in a child who has had a febrile convulsion in the past, immediately begin measures to reduce the fever.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• For recurrent, frequent, febrile seizures, laboratory studies of blood and spinal fluid and electroencephalography (studying the brain by measuring electric activity ["brain waves"]).

APPROPRIATE HEALTH CARE

• Doctor's treatment for diagnosis and treatment of the underlying cause.
• Home care after the seizure has subsided and after diagnosis.

POSSIBLE COMPLICATIONS

• Body injury during a seizure.
• Brain injury with repeated seizures.
• Children with febrile seizures are at greater than average risk to develop epilepsy later in life.
• Recurrence risk is about 33%; almost all that recur do so within the one year.

PROBABLE OUTCOME--

• Despite its frightening appearance, a convulsion caused solely by fever in a child is usually not serious. However, other causes should be investigated.
• Seizures do not cause retardation, developmental delays or behavioral abnormalities.
• If the first convulsion with fever occurs in a child younger than 6 months, a neurological examination and other studies may be necessary.

How To Treat

GENERAL MEASURES--

• During the convulsion, move potentially dangerous objects away from the child. Lie the child on its side, be sure airway is open.
• Write down details of the convulsion, and report them to the doctor. Information should include the following: When did it begin? How soon did the seizure occur after the fever rose? Were the limb movements equal on both sides or was one side twitching more than the other? How long did the seizure last? Did the child sleep afterward? If so, how long? Did the seizure recur after a quiet interval?
• After the convulsion, try to reduce fever with a tepid sponge bath.

MEDICATION--

• Your doctor may prescribe anticonvulsant drugs, such as phenobarbital, to prevent a recurrence of seizures. Some doctors recommend medication after the first convulsion; many doctors treat only if a seizure recurs. Anticonvulsant drugs are only effective if taken daily during the susceptible years (up to age 4).
• Use acetaminophen for fever.

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--Nothing by mouth during seizure. After the seizure ends, encourage the child to drink extra liquids, including water, tea, cola and fruit juice.

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.