February Convulsions (Febrile Seizure)

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Last Medical Review: April 5, 2020
Medically Reviewed by Dr. Elisabeth Vincent Hamelin
Febrile Convulsions (April 5, 2020)

What are

The seizure episode must be considered a particular reaction of the nervous system to the rise in body temperature above 38.5 °C. It generally appears in children aged between 6 months and 5 years. The febrile convulsion usually occurs on the first day of the febrile episode, has a duration that varies from 3 to 15-20 minutes, is more frequent in the male sex, has the highest incidence in children under the age of two and then decreases progressively with increasing age, and is more frequent in children born to mothers who have continued to smoke or consume alcohol during pregnancy. A second seizure episode may follow, usually within a year. Further subsequent episodes have a 50% chance of occurring.

How they manifest

During convulsive access, the child initially and briefly presents eyeballs deviated from one side, pupils dilated or narrowed, upper eyelids lowered in half, pale face, wrinkling of the forehead and eyebrows, abdomen retracted and hollowed out ” a boat ”, stiff limbs often in an attitude of flexion, frequent and irregular pulse, with suspension of breath. This first phase of very short duration is followed by one consisting of a succession of jolts or jolts, change of face color from pale to red, jerky breathing. Access usually resolves after 2-4 minutes, but can last up to 15-20 minutes.

What are the risks

The appearance of febrile seizures, regardless of the age of onset of the 1st episode and recurrences, may increase the overall risk of epilepsy, a risk that however remains linked to the familiarity of epilepsy in siblings and parents, while it does not alter nor behavior or intellectual and motor skills of the child.

What should be done

In the child with fever, one must first of all try to bring the body temperature back to normal values ​​using all possible means:

  • rid the body of excessive clothing;
  • administer Paracetamol (e.g. Tachipirine) 10-15 mg/kg dose, 4-5 doses per day;
  • apply sponges of warm water and/or the ice pack;
  • if despite all this a convulsion occurs it is very important not to lose your temper. Convulsion can be controlled at home with sedatives administered rectally and it is therefore necessary to learn perfectly what to do with the help of your doctor.

The notes below are intended to provide a reminder of the generally recommended intervention.

  • Ensure good breathing for the child, preferably by placing him on his side.
  • Immediately administer, at the dose and at the times indicated by the doctor, a rectal sedative (e.g. Valium ampoules, using an insulin syringe without a needle), repeating the dose if the first one should be expelled or if the crisis did not recede within a short time .

    Only in the event that this measure does not have a rapid effect, transport the child to the nearest pediatric hospital ward.

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