Febrile Seizures 2022

 

Febrile Seizures

Are you familiar with febrile seizures? If you aren’t brushed up on your Latin, The word febrile refers to having a fever. Someone who is afebrile has a normal body temperature. For parents who have no idea that these exist, the first time it happens it is often described as one of the most horrifying moments of their life. Awareness helps. It is by no means a fun experience, but it is nowhere near as terrifying as it appears. General statistics indicate that seizures happen in about 4 -5 % of all children. If you have a family history of them, this puts your child at a bit of an elevated risk. Most of the time the first febrile seizure happens between 6 months and 3 years. Typically kids completely outgrow them by the time they are five. These seizures are NOTassociated with epilepsy.  The symptoms may range from smaller tremors to large jerky movements. The eyes may roll back. Some kids actually lose consciousness. It is common for kids to seem quite drowsy and "out of it" for a period of time right afterwards. Please note that It is very common for kids who are in the process of spiking a fever to look quite pale and seem a bit trembly; that is NOT usually a seizure. The seizures themselves do not usually lead to any ongoing medical issues, but care needs to be taken to make sure the child doesn't sustain an injury or choke while they are seizing.  If you see your child having a seizure your primary job is to keep them safe. Immediately remove them from any water, ledges, traffic...etc. If your child is laying down, turn them on their side. Don't stick anything in their mouths. Make sure their airway remains open.  Do not try to put them in the tub or give fever medications when they are in the midst of a seizure! Link:  Basic seizure first aid Febrile seizures usually come on when a fever is in the process of shooting up rapidly, but it is NOT the fever that is causing the seizure; the trigger is whatever is causing the inflammation. That being said, it is rare to have them associated with a temperature under 102. Febrile seizures usually last less than 2 minutes. If you are able to stay calm enough, take a look at a clock, watch or phone to get a sense of the time. If a seizure is lasting longer than a minute (especially if it is the first time) it is perfectly appropriate to call 911. If the seizure is short and your child seems stable you don't need an ambulance, but you still should get them some medical attention right away.  One of the things you want to figure out is the source of the fever. Viral syndromes are the most common cause, but the medical team will want to have the other suspects ruled out (ears, throat, lungs, urine.) Once your child has had one febrile seizure, they have a lower threshold and unfortunately it can happen again. It is important to keep in mind that fevers are the body's way of fighting an infection. As long as a fever is lower than the 101 range and the child seems happy, I generally tend to leave the low grade temps alone and not treat. This was not the case with my seizure prone patients. I was in the habit of being a bit more aggressive with those little ones.  I learned recently that there is new data about this. It turns out that while this might make your child more comfortable, it isn’t likely to prevent subsequent seizures. In any event, have the correct medications on hand and make sure you stay up to date with the proper dosage for your child’s weight. Dr. Ted’s Research: Those recent studies that show that keeping the fevers down won’t necessarily prevent recurrent seizures can be hard to wrap your head around. This is a good example of something called a “true-true-unrelated phenomena." In these kids something is causing inflammation. It is the inflammation which is causing the seizure. The same inflammatory process is causing the fever. It is NOT the fever causing the seizure. Sometimes the seizure actually occurs before the fever. In any case, as Nurse Judy mentioned above, keeping the fever down doesn’t seem to alter the potential for having a seizure.