Seizures Fever ( Febrile Convulsion )

DEFINITION

Seizures Fever (Febrile convulsion) is a seizure that occurs in infants or children due to fever, the absence of infection in the central nervous system as well as other neurological disorders.

A child who has a febrile seizure does not mean he suffers from epilepsy, because seizures in epilepsy is characterized by recurrent seizures that are not triggered by the presence of fever.

Febrile seizures occur in about 2-5% of children aged less than 6 years old, but most often occurs in children aged 6 months - 3 years. Febrile seizures tend to be passed down in families.

Febrile seizures can make a family anxious, but in fact harmless. However, during a seizure takes place, there is the possibility that the child will suffer injury due to falling or choking on food or saliva alone. Has not been proven that febrile seizures can cause brain damage. Research shows that children who have experienced febrile seizures have normal intelligence and achievement in school.

95-98% of children who have experienced febrile seizures do not progress to epilepsy. But some children have a high risk of suffering from epilepsy, if:

- Prolonged febrile seizures

- Seizure only on certain body parts

- Recurrent febrile seizures within 24 hours

- Children suffering from cerebral palsy, growth disorder or other neurological disorders.

CAUSE

Most febrile seizures occur because of the drastic changes in body temperature suddenly, and most often occurs on the first day of fever.

Viral or Bacterial Infection

Usually, fever triggering febrile seizures are caused by a viral or bacterial infection in children, such as respiratory tract infections or ear infections. On a mild infection, infection and febrile seizure itself is not dangerous. However, it can sometimes life-threatening infections, such as infections of the brain (encephalitis) or the lining of the brain (meningitis) can cause convulsions and fever in children. This disease can also cause seizures without fever in children.

Seizures Post-Immunization

May increase the risk of febrile seizures after children receive certain immunizations, such as DPT or MMR immunization. Not too high fever can sometimes occur after a child gets immunized. In the event of a febrile seizure, then this is caused by a fever that arise after immunization, not as a result of immunization itself.

Febrile seizures tend to be found in one family, so it is thought to involve heredity (genetics).

SYMPTOMS

The symptoms in children who experience febrile seizures among others:

·         there is a fever, the body temperature of more than 38oC

·         loss of awareness, the child does not respond to the call of his parents

·         eyes glared up

·         seizures arise, the child's body shaking, hands and feet jerky

·         Sometimes children do not breathe, and can be blue

·         child may vomit or bite his tongue

·         the child may cry or moan

·         incontinence. Children can bedwetting or defecate outside consciousness.

Febrile seizures can be divided into:

·         Simple febrile seizures, febrile seizures are the type most often occur. Seizures lasting for a few seconds to 15 minutes. Febrile seizures are not recurring within 24 hours thereafter. Seizures that occur are comprehensive and not only about the one particular body part.

·         Complex febrile seizures. Febrile seizures lasting more than 15 minutes, occur more than once in 24 hours, or the seizure is limited to one side of the child's body.

After the seizure is usually a child will come back unconscious. But the child does not remember what happened. Some children may feel sleepy and there is also a dazed (temporary and mild in nature).

DIAGNOSIS

Diagnosis is based on the existence of a seizure in a child who has a fever and no prior history of epilepsy. The body temperature is measured to ensure presence of fever. Then examined to find the cause (physical examination, blood, and urine).

Febrile seizures usually do not require further examination to seizures, such as EEG, CT scan of the head, and lumbar puncture. Inspection can be done if:

·         seizures in children aged less than 9 months and over 5 years

·         the child has a disorder of the brain, nerves, or in development '

·         seizure is limited to one part of the body

·         seizure lasts more than 15 minutes

·         the child has more than one febrile seizure in 24 hours

·         children have abnormal findings when examined, for example, the possibility of infection in the central nervous system

TREATMENT

Things that need to be done during a seizure:

·         Place the child in a safe place. Children can be placed on the floor covered by a thick blanket.

·         Remove objects that can make a child injury

·         Loosen tight clothing, especially around the neck. If possible, open or remove clothes from the waist up

·         If the child vomits, or a lot of saliva or mucus in the mouth, put the child tilted to the side, so that the liquid can flow out and the child does not choke. In addition, this position also prevents the tongue blocking the airway.

·         Do not attempt to insert anything into the child's mouth to prevent children from biting his tongue, as this increases the risk of injury and airway obstruction.

·         Do not attempt to restrain or stop the seizure movements by holding child

·         Do not try to give fever-reducing medicines when children seizures, because the risk for choking.

·         Most febrile seizures stop on their own within a few minutes (less than 15 minutes).

·         The child should be immediately taken to the nearest hospital if seizures still lasts more than 10 minutes, recurrent seizures, the child has difficulty breathing or body blue, and the child looks letargis.

After that, the cause of the fever also needs to be known and addressed by bringing the child to the doctor.

Fever in children can be overcome by:

·         Give febrifuge, such as Ibuprofen. Aspirin should not be used to treat fever in children because of the risk for the occurrence of Reye syndrome.

·         Compressing the child. Do not compress the child with cold water or alcohol as it may make the fever worse.

PREVENTION

In most cases, febrile seizures occur in the first few hours when the child has a fever, where an increase in body temperature. Seizures can occur when the body temperature rises or falls rapidly. In most cases, seizures can occur unexpectedly or can not be prevented.

Ways to help reduce the risk of febrile seizures in children:

·         Give febrifuge when the child has a fever Image of giving medicine

·         Make sure children drink enough fluids

·         Make sure the child is not dressed too thick, to help control fever

·         The use of drugs as an anti-seizure prevention is not recommended in general, because there is a risk of side effects from the use of these drugs, such as difficulties in learning, sleep disturbances, irritability, hyperactivity and impaired breath.

REFERENCE

- D, David C. Febrile Seizures. Medline Plus. 2010.

- D, Yamini. Febrile Seizures. Kids Health. 2012.

- M, Margaret C. Seizures in Children. Merck Manual Home Health Handbook. 2009.

- Mayo Clinic. Febrile Seizures. 2012.