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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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Febrile seizures and SIDS - sudden infant death syndrome - Brief Article
From Pediatrics for Parents, 12/1/01

The cause of sudden infant death syndrome (SIDS) continues to elude researchers. Doctors in Denmark recently examined the possible connection between febrile seizures and SIDS. Both are age-related, occurring in younger children and infants, and may have a common mechanism - lack of blood flow to the brain.

One interesting finding that supports a possible relationship between febrile seizures and SIDS is how cats react to artificially induced fevers. Young kittens tend to die suddenly, older kittens are more likely to have a seizure, and mature cats have neither.

The doctors looked at the medical records of nearly 10,000 children ages three to sixty months old who had a febrile seizure. None of these children had a history on non-febrile seizures, cerebral palsy, severe head trauma, intracranial tumors, meningitis, or encephalitis.

These children were compared to over 20,000 siblings who never had a febrile seizure, looking at the rate of SIDS in both groups. (SIDS is know to be more likely among siblings.) They found no increase in the risk of SIDS due to febrile seizures.

Although this study didn't find a cause or SIDS, it did help by eliminating one possible cause.

Archives of Diseases of Childhood, 2/02.

COPYRIGHT 2001 Pediatrics for Parents, Inc.
COPYRIGHT 2002 Gale Group

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