Febrile seizures are seizures that can occur in children between 1 and 5 years of age in association with a high fever. There are two types of febrile seizures: simple febrile seizures and complex febrile seizures. Simple febrile seizures usually last less than 15 minutes and do not recur within 24 hours. In contrast, complex febrile seizures last longer than 15 minutes or have frequent recurrences, especially before the age of 3 years.

In the event of a febrile seizure, it is important to call an ambulance immediately and bring the child's temperature down quickly. It is also crucial to protect the child from trauma and ensure that the airway is clear. After the episode, the child should be examined by a physician to determine the cause of the fever and seizures.

It is also important to understand the causes of febrile seizures, which may be related to viral or bacterial infections, as well as other illnesses. Ways to prevent febrile seizures include controlling fever with medications, such as paracetamol and ibuprofen, as well as vaccinations for infections that can cause fever. Finally, treatment options for febrile seizures include anticonvulsant medications, which can be used to prevent recurrences of complex febrile seizures.

Definition and Meaning

Febrile seizures are a type of seizure that occur in children aged 6 months to 5 years in association with a high fever. They are usually caused by a viral or bacterial infection, and are more common in children who have a family history of febrile seizures. Febrile seizures can be frightening to watch, but they are usually mild and often resolve on their own without medical treatment. However, it is important to see a doctor if your child has a febrile seizure to identify the cause of the fever and prevent any serious complications.

Causes

Febrile seizures are related to an elevated temperature, often above 39°C, unrelated to a central nervous system infection. The maximum risk is around the 2nd year of life, and then decreases with age.

Types of febrile convulsions

There are two types of febrile convulsions:

simple febrile convulsions,
complex febrile convulsions.

Simple febrile convulsions concern children from 6 months to 5 years old, with no previous neurological history. It is a generalized seizure, lasting less than 15 minutes with a normal neurological examination after the seizure. The victim has no signs of meningitis and no recurrence within 24 hours.

Complex febrile seizures last longer than 15 minutes or have recurrences. Recurrences are common, on the order of 30% to 40%, occurring mostly before the age of 3 years and within 1 year of the first episode.

Symptoms

During the seizure, the infant convulses, there is sometimes a revulsion of the eyes, he does not cry and he is unconscious. After 30 minutes, it is a convulsive state of illness. Sometimes the convulsion precedes the fever.

Prevention and treatment

An emergency medical service should be notified immediately by calling 911.
Try to bring the child's temperature down quickly by undressing the child completely and wetting him or her with warm water without wiping.
It is important to protect the child from trauma.
Ensure that the child's upper airway is freed by placing him or her in the lateral safety position.

The child must be examined by a doctor after the episode. The doctor's role is to make sure that the convulsion is due to fever, to eliminate a central nervous system infection such as meningitis or encephalitis, to specify the origin of the fever (viral infection, otitis, angina...), and to specify if the hyperthermic crisis is simple or complicated. If it is complicated, an EEG (Electroencephalogram) will allow to discuss the interest of an anti-epileptic treatment.

The pediatrician may prescribe intra-rectal Valium to be injected with a cannula if there is a risk of recurrence of the seizure. It is important to note that febrile seizures can be serious if they last longer than 10 minutes, recur very often, involve an infant younger than 9 months or a child older than 5 years, or are accompanied by abnormal neurologic signs.

Bottom line

Febrile seizures are high temperature-related seizures common in children ages 1 to 5 years. It is important to understand the causes, symptoms and treatment options available to prevent and treat these seizures. If a febrile seizure occurs, it is important to contact an emergency medical service immediately and follow medical instructions to protect the child's health.