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WHAT  ARE  FEBRILE  CONVULSIONS?

 

Febrile convulsions are fits experienced by babies and young children. Affected infants may turn blue, stiffen, clench their fists, twitch uncontrollably and lose consciousness for anything from a few seconds to five minutes. Short convulsions are more usual. Although febrile convulsions are extremely alarming, in the majority of cases they are harmless.

 

Febrile fits are not the same as epileptic fits. Their cause is usually a sudden rise in body temperature (the word febrile means fever) as a result of a minor childhood illness - a middle ear infection, for example. The child's immature brain reacts to this sudden change in temperature by firing off abnormal electrical impulses, although it is not known why this happens. Only 2 per cent of children who suffer from febrile fits go on to develop epilepsy.

 

Children at risk

 

• Around 5 per cent of children suffer from febrile convulsions at some time and the condition has a tendency to run in the family. 
• The risk is higher in children who suffer frequently from illnesses that involve a raised temperature and in those who have already had a febrile convulsion. 
• Febrile convulsions are most common in children aged six months to three years, but can occur up to the age of five. Most children do grow out of them. This may be because their temperature control mechanisms and brains have matured sufficiently to cope with a rise in temperature. 

What happens?

 

• The first sign that a child may be at risk of having a convulsion is if his temperature rises rapidly. 
• He may then start to look vacant and his muscles may begin to twitch.  
• The child's head will be thrown back, his eyes will roll up and his whole body will jerk uncontrollably; his skin will look blue. In a short time, the child will lose consciousness. 
• Depending on the severity of the convulsion, this state can last from a few seconds to a few minutes. 
• Afterwards, the child will go limp and then gradually regain consciousness, before falling into a natural sleep. 

When to call the doctor

 

• The first time, a febrile convulsion occurs, call your doctor  immediately. Your child may need to go to hospital so that a proper evaluation can be made and causes other than rise and temperature can be excluded. This evaluation is not normally repeated if your child has another convulsion. However, you should notify your doctor so he can make sure that your child's fit was caused by a minor infection. 
• If the convulsion lasts for more than five minutes or your child has repeated convulsions, you must seek urgent medical attention.
• After the convulsion, make an emergency call to your  doctor if your child has acute nausea, tremors a rash, poor coordination, a dislike of bright lights, a severe headache or a stiff neck. Your doctor will want to rule out the possibility of any serious illness, such as meningitis. 

What you can do

 

If you realize that your child is having a febrile convulsion, you need to take immediate steps to lower temperature. This is because the convulsions are usually triggered by a fever.

 

Lower the room temperature and strip your child down to his nappy or underwear. Put pillows or soft padding around him to prevent injury. 

Sponge your child down, using tepid water. Do not let his temperature drop so low that he becomes cold. 

Once your child’s temperature is controlled, His convulsion will stop. Place him on his side and make him comfortable. Keep checking his level of response and breathing until he recovers. 

Guidelines

 

It can be extremely frightening the first time you see your child have a fit. Try to keep calm and follow these simple rules:

 

• Remove any hard or sharp objects nearby, such as a chair or a table that has sharp corners, so that your child does not hurt himself while he is thrashing about. 
• Do not attempt to restrain your child in any way. 
• Do not try to put anything in your child's mouth to stop him biting his tongue or lips - this rarely happens and, if it does, having something in his mouth is more dangerous. 
• Once the fit has passed, place your child on his side (or into the recovery position, if possible) so that any secretions or vomit can drain out of his mouth. 

Treatment and investigation

 

• To prevent further fits, give regular doses of paracetamol or ibuprofen when his temperature rises, or for the first 12 hours after a vaccination. If he is still hot, sponge him down with tepid water. 
• If a convulsion lasts for more than five minutes, or if your child experiences a succession of fits in the same hour, a diazepam (Valium) suppository may be administered by the hospital or doctor. 
• Your child may have to stay in hospital for tests. Blood and urine samples will be analysed to rule out a more serious cause. 
• Other tests include a lumbar puncture to check the spinal fluid for signs of infection, and a brain scan (CAT scan) to eliminate the possibility of a brain disorder. 

If the convulsions are unusual in some way, a CAT scan may be used to investigate the cause. 

 

Other causes of convulsions

On rare occasions, a convulsion may have a more serious cause than a mild childhood infection, such as:

 

Birth injury: damage to brain tissue, usually caused by a difficult labor.

 

Infection of the brain: such as meningitis and encephalitis.

 

Damage to the brain: a brain hemorrhage, tumor or a skull fracture.

 

Epilepsy: recurring seizures without fever.

 

Asphyxia: may occur after a severe attack of whooping cough.

 

Immunization: the measles vaccine in the MMR injection can cause a febrile convulsion 8-1 0 days afterwards. However, it is more likely that your child will have a fit while suffering from measles than he will if he receives the vaccination.

 

Rickets: a severe lack of vitamin D can irritate the membranes of the brain, so triggering a convulsion.

 

Please  call 966-2-690-5021 (Jeddah)  for  an ambulance  assistance.

 

For  More  Information:  Please  consult  your  physician  on  your  next  visit.