Febrile Seizures (Fever Seizures) Uncovered

 A febrile seizure (or fever seizure) is a type of seizure triggered by a fever (a temperature above 38°C) in children aged between 6 months and 5 years, without any infection of the brain or spinal cord.

It is usually generalised in nature. This means that there could be muscle stiffening followed by rhythmical jerking or shaking of the limbs, which may be asymmetrical. The seizure may also involve twitching of the face, rolling back of the eyes, staring and losing consciousness.

1. Simple Febrile Seizures:

• Last less than 15 minutes.
• Do not recur within 24 hours or during the same illness.
• Full recovery happens within an hour.

2. Complex Febrile Seizures:

• May involve movement in just one part of the body (known as ‘focal’ seizure)
• Last more than 15 minutes.
• May recur within 24 hours or during the same illness.
• Recovery may take longer than an hour.

Seizures lasting over 5 minutes may be prolonged, so it’s advised to call an ambulance if a seizure continues for more than 5 minutes.

• Unknown exact cause: Believed to result from a child’s developing brain reacting to a fever, possibly with a genetic predisposition.
• Genetics: Risk is higher if a parent or sibling also had febrile seizures.
• Viral Infections: Responsible for about 80% of cases; common triggers include viruses like HHV-6, RSV, adenoviruses, and others.
• Other Infections: Any infection causing fever, such as colds, ear infections, or stomach bugs (causing diarrhoea and sickness), can lead to febrile seizures.
• After Immunisations: Rarely, a febrile seizure may occur following a vaccination, though immunisations are essential to help children develop immunity against      serious infections. This helps your child to be better able to prevent future febrile convulsions, and hence it is advised to complete immunisation as usual.

• Typically occurs between 6 months and 5 years, with a peak between 12 and 18 months.
• Higher fever, rather than how fast the fever rises, is a stronger risk factor.

• Most children with febrile seizures experience no lasting effects and develop      normally.
• A third of children may have another seizure after their first one.

• Your healthcare provider will assess your child and try to find the cause to fever/ seizure as well as rule out any other alternative condition. 
• They will also rule out any red flag signs of fever to make sure your child is not more unwell. 

• Meningitis (Brain infections)
• Shivering 
• Confusional state 
• Faints 
• Breath holding spells 
• Low blood sugar 
• Drug use or withdrawal 
• Other complex neurological conditions

If your child has a febrile seizure:

1. Stay Calm and Provide Immediate Care:

• Note the start time of the seizure.
• Cushion their head and remove any harmful objects from the area.
• Do not restrain the child or put anything in their mouth.
• Keep them away from danger.
• Once the seizure stops, turn the child on their side in the recovery position.
• Observe the child until they are fully recovered.
• Do not give any food or drink until your child fully recovers.
• Check for any injuries and seek medical help if needed for these.

2. If the Seizure Lasts More Than 5 Minutes:

• Call an ambulance.
• If prescribed by a specialist, you may need to give emergency medication, such as buccal midazolam or rectal diazepam.

• If it’s your child’s first febrile seizure, they are under 18 months, or there’s      uncertainty about the cause.
• If there are any signs of a more serious infection, such as meningitis.
• If your child has a complex seizure, any lasting weakness, or a lower level of      alertness before or after the seizure.
• If your child has recently been on antibiotics.
• If you are quite anxious or unable to cope.

• Febrile seizures are not the same as epilepsy, and the risk of epilepsy developing      later is low.
• Most febrile seizures stop on their own within 2-3 minutes.
• As children grow, the chance of febrile seizures decreases.
• It’s advised to let fevers run their course unless the child is very      uncomfortable.
• Not every fever or illness would provoke a febrile convulsion.
• About 1 in 3 children will have another febrile convulsion in future.
• Usually, no specialist medication is needed for future. 
• Routine use of medicines to prevent fever like Paracetamol and/or Ibuprofen is not      recommended as this does not reduced or prevent febrile convulsion recurrence.      These should only be used when your child is distressed or uncomfortable.

Febrile seizures may be frightening, but understanding them and knowing how to respond can help ensure your child remains safe during an episode