Febrile seizure in young children

May, 27/2019 - 07:53

Febrile seizures are convulsions that can occur in young children when the body temperature suddenly spikes to over 38.5°C. They occur mostly in children aged six months to five years.

Dr. Nguyễn Thị Quỳnh Hương. Photo courtesy of Hanoi French Hospital

By Dr. Nguyễn Thị Quỳnh Hương

Febrile seizures are convulsions that can occur in young children when the body temperature suddenly spikes to over 38.5°C. They occur mostly in children aged six months to five years.

The seizures can look serious, and it can be frightening and distressing to see your child having one, particularly if it is the first time.

The seizures, however, are usually harmless and stop by themselves after a few minutes, and typically do not indicate a long-term or ongoing problem.

Causes of febrile seizures

The actual cause of febrile seizures is unknown, but they are linked to a fever onset. Any childhood infection causing a fever can cause a febrile seizure. Common childhood infections include the flu, a urinary tract infection, chickenpox, measles, and an ear or a throat infection. In rare cases, children often experience a febrile seizure after a routine vaccination.

If one of your children has had a febrile seizure, it is also believed that siblings have an increased likelihood to develop them.

Signs and symptoms 

Symptoms may vary from mild to severe, and typically display one or more of the following signs, the child:

·         the eyes may roll back

·         the body may become stiff, and arms and legs may begin to twitch and jerk

·         loss of consciousness may occur

·         the child may wet or soil themselves

·         the child may throw up or foam at the mouth

A typical seizure like that will last for up to five minutes and occur only once during an illness.

Sometimes though your child may experience what is called a complex seizure which may last for longer than 15 minutes. In that case, a seizure can happen again during the time your child is ill and has a fever.

What happens after a seizure?

After the seizure, your child will most likely feel better or just go back to normal.

What should you do during a seizure?

If your child has a seizure, make sure you stay with them and don’t place anything in their mouth as she may bite her tongue or choke.

Place the child in a recovery position and record the amount of time so you know how long the seizure lasts.

The following are simple steps on how to achieve a recovery position:

·         Place the child on her back, then kneel on the floor at her side.

·         First extend the arm nearest to you at a right angle to the child’s body with the palm facing up. Then take the other arm and place it so the palm rests on the cheek closest to you and hold it in place.

·         With your other hand, bend the child’s knee farthest from you to a right angle, and then carefully roll the child onto her side by pulling on the bent knee.

·         The bent arm should now be securing the position if the head and the extended arm stop her from rolling on her belly.

·         The bent leg has to stay at a right angle to provide the position’s stability.

·         Gently tilt the child’s head backwards and lift her chin. This will open the airways. Also, carefully check that nothing blocks the airways, but be careful as she may bite.

When should you see a doctor?

You should always see a doctor and have your child properly examined after a seizure to make sure nothing serious is going on.

Seek immediate medical attention if your child is having a seizure for the first time, a seizure lasting for more than five minutes, has breathing difficulties, or shows signs of severe dehydration, which means a lack of fluid in her body. Signs of dehydration include:

·         very little or no urine over the last eight hours

·         a dry mouth and tongue

·         sunken eyes

·         a lack of tears when crying

·         a sunken fontanelle – the soft spot usually found at the top of a young child's head

When seeing the doctor, you should describe what happened during the seizure, as it will most likely be over by the time you arrive at the hospital. What is important for the doctor to know is:

·         was it a first seizure or has it happened before

·         how long did the seizure last

·         what symptoms did the child show – stiffening of the body, twitching of the face, jerking arms and legs, staring, loss of consciousness, passing urine or stools

·         how did your child feel afterwards, and how long did it take for her to return to normal

After that, the doctor will examine your child and usually order tests such as blood or urine samples to determine the cause of your child’s illness.

It is usually recommended to admit your child to the hospital to keep her under observation and do further tests, especially if the child is younger than 12 months or shows signs of a complex febrile seizure.

Additional tests may include:

·         an electroencephalogram (EEG) – This measures your child's electrical brain activity by placing electrodes on the scalp. It can discover whether your child has a febrile seizure or epilepsy.

·         a lumbar puncture – If doctors suspect an infection of the brain or the nervous system, they will order a lumbar puncture whereby a small sample of cerebrospinal fluid (CSF is the fluid surrounding the brain and the spinal cord) is removed with a needle for testing.

·         magnetic resonance imaging (MRI) – This determines whether there is any structural abnormality in your child’s brain, which could explain the seizure.

Most of the time, your child will completely recover and will not have to stay in a hospital for more than a couple of days.

Children who experience uncomplicated febrile seizures will not require any medication or further treatment and will recover without problems. Although serious underlying conditions and the risk to develop epilepsy are generally rare, it is important to get your child thoroughly checked to make sure she is fine.  HANOI FRENCH HOSPITAL 

*Dr. Nguyễn Thị Quỳnh Hương works in the Pediatrics and Neonatal Department at French Hospital Hà Nội. If you have questions, please book an appointment with our doctors, or contact us at 84 – 24.3577.1100, or access our website at www.hfh.com.vn, or email us at contact@hfh.com.vn. Address: 1 Phương Mai, Đống Đa, Hà Nội