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Febrile seizure

A febrile seizure, also known as a fever fit or febrile convulsion is a generalized convulsion caused by elevated body temperature. They most commonly occur in children below the age of three years old and should not be diagnosed in children under the age of 6 months or over the age of 6 years. In many cases, the first sign of fever is the onset of the seizure. It has been theorized that the seizure is triggered by the rapidity of the rise in temperature, rather than the actual temperature reached. more...

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Febrile seizures represent the meeting point between a low seizure threshold (genetically and age determined) - some children have a greater tendency to have a seizure under certain circumstances - and a trigger: fever. The genetic causes of febrile seizures are still being researched. Some mutations that cause a neuronal hyperexcitability and could be responsible for febrile seizures have already been discovered.

The diagnosis is one that must be arrived at by eliminating more serious causes of seizure: in particular, meningitis and encephalitis must be ruled out. Therefore a doctor's opinon should be sought and in many cases the child would be admitted to hospital overnight for observation and/or tests. As a general rule, if the child returns to a normal state of health soon after the seizure, a nervous system infection it is unlikely. Even in cases where the diagnosis is febrile seizure, doctors will try to identify and treat the source of fever. In particular, it is useful to distinguish the event as a simple febrile seizure - in which the seizure lasts less than 15 minutes, does not recur in the next 24 hours, and involves the entire body. The complex febrile seizure is characterized by long duration, recurrence, or focus on only part of the body. The simple seizure represents the majority of cases and is considered to be less of a cause for concern than the complex. It is reassuring if the cause of seizure can indeed be determined to have been fever, as simple febrile seizures generally do not cause permanent brain injury; do not tend to recur frequently, as children tend to 'out-grow' them; and do not make the development of adult epilepsy significantly more likely.

Children with febrile convulsions who are destined to suffer from afebrile epileptic attacks in the future will usually exhibit the following:

  • A family history of afebrile convulsions in first degree relatives (a parent or sibling)
  • A pre-convulsion history of abnormal neurological signs or developmental delay
  • A febrile convulsion lasting longer than 15 minutes
  • A febrile convulsion with strong indications of focal features before, during or afterward


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Predicting febrile seizures - includes definition of febrile seizure
From Pediatrics for Parents, 6/1/93

Almost five percent of children three months to five years old have at least one febrile seizure. Even though febrile seizures are not serious from a medical perspective, any seizure can be very frightening for a parent. Most parents have little knowledge about febrile seizures until their child has one. Those with an understanding of these seizures are more likely to treat the seizure appropriately. Unfortunately, there is no way to predict which children will have a febrile seizure.

Although there is no way to accurately predict which children will have a first febrile seizure, there may be factors that increase the risk of a child having a febrile seizure. A retrospective study of 150 children, half experiencing a febrile seizure and half as controls, found four factors that seem to indicate an increased risk of having a febrile seizure. The four factors found to increase the risk area family history of febrile seizures in a first- or second-degree relative, day care attendance of more than 20 hours per week, discharge from the hospital at 28 days of age or later, and parental impression of slow development. Over three percent of children have two or more of these factors, but their risk of having a febrile seizure is about 28%.

Most children who have a first febrile seizure have none of these risk factors. Since parental education about febrile seizures before the seizure occurs leads to less fear and more appropriate treatment, ideally all parents should be taught about them. More realistically, parents with children at risk for febrile seizures should receive extra counseling about this very scary problem.

American Journal of Diseases of Children, 1/93, pp. 35-9.

COPYRIGHT 1993 Pediatrics for Parents, Inc.
COPYRIGHT 2004 Gale Group

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