DOCSLIB.ORG

Febrile Convulsions

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Febrile Convulsions Children’s Health Queensland Hospital and Health Service fact sheet Emergency Department Febrile convulsions What are febrile convulsions? When should you see someone? A febrile convulsion is a seizure or fit that occurs All children should be seen by a doctor after a febrile with fever, usually in children under five years of age. convulsion. The doctor will ensure that the convulsion Approximately one in 25 children (four per cent) will was due to a fever and will also look for the cause of experience a febrile convulsion at some time. the fever. This will involve an examination of your child and possibly some tests. Febrile convulsions often occur during the early stages of an illness when there is a rapid rise in body temperature. This means your child may have a febrile Care after a febrile convulsion convulsion before you even realise they are unwell. ■ Sometimes children who have febrile convulsions, particularly prolonged ones, will need to be ob- It is a very scary experience for most parents but does served in hospital for a period of time. not harm the child. ■ When your child is discharged from hospital, What causes febrile convulsions? resume your usual routines. The exact reasons behind febrile convulsions is ■ Your child may be ‘out of sorts’ for a day or so but unknown. We do know that children in general have a this will pass. lower seizure threshold than adults so they are more ■ No medications are required except paracetamol or prone to seizures. ibuprofen as you would usually use them. Regular paracetamol or ibuprofen does not prevent further Seizures are caused by a spike or rapid firing of febrile convulsions. the neurons (nerves) within the brain. In febrile convulsions this occurs when there is a rapid change in Follow up the body temperature of the child. ■ Usually no further investigations or follow up is The fever itself may be caused by any infection required after a first febrile convulsion. including viral upper respiratory infections (cold or flu), ■ Febrile convulsions do not cause brain damage and ear infections, pneumonia, bacterial diarrhoea and, will not affect your child’s development. more rarely, infection in the blood stream (sepsis) or infection around the brain (meningitis). Things you can do at home A child who has a febrile convulsion has no more If you witness your child having a seizure, you should chance of having a serious infection than any other apply basic principles of first aid. child with a fever. ■ First ensure that your child is safe (e.g. away from the edge of a bed and away from sharp or danger- Signs and symptoms ous objects that could injure them) Parents usually observe in the child: ■ ■ Roll your child onto their side when the seizure »body stiffening is over »sharp jerking movements of their arms and legs ■ Call for an ambulance (000) if the seizure lasts »head arched back more than 5 minutes » eyes rolled back ■ If your child is not breathing, give mouth-to-mouth ■ The child is unresponsive during the convulsion resuscitation ■ Typically convulsions last for less than 15 minutes ■ consider doing a first aid course (on average around 90 seconds). The child is usually drowsy afterwards Will your child have another convulsion? Studies have shown: Important facts about febrile convulsions ■ Around 1 in 3 children (33 per cent) who have a ■ 1 in 25 children (4 per cent) will experience febrile convulsion will go on to have a second one. a febrile convulsion at some time, usually This is most likely to occur between the age of 12 before 5 years of age and 24 months. ■ 1 in 3 children who have a febrile convulsion ■ Around 1 in 15 children (7 per cent) who have a will have a second one febrile convulsion will have three or more febrile ■ Febrile convulsions are caused by a rapid convulsions. change in body temperature associated with ■ Most children will outgrow the tendency to have infection febrile convulsions by the age of 4 years. ■ Febrile convulsions do not cause any ■ Febrile convulsions do not mean your child will damage to children’s brains or affect their go on to have epilepsy (recurrent seizures in the development absence of fever). ■ If you witness a febrile convulsion, you should ensure the child’s safety and call Preventing febrile convulsions an ambulance (000) It is not always possible to take steps to prevent ■ A child who has a febrile convulsion has no febrile convulsions as often they are the first sign of more chance of having a serious infection illness. than any other child with a fever Some tips to manage a fever: ■ Children’s paracetamol (Panadol) or ibuprofen (Nurofen) may help reduce temperature and make them feel a little better (this has not been shown to Contact us prevent febrile seizures) Lady Cilento Children’s Hospital ■ Avoid overdressing your child 501 Stanley Street, South Brisbane t 07 3068 1111 (hospital switchboard) ■ Avoid cold bathes that may cool your child too In an emergency, always contact 000 for immediate assistance. rapidly FS012 developed by the Emergency Department, Lady Cilento Children’s Hospital. In most cases antiseizure medications are not Updated: June 2o15. recommended as they have significant side-effects All information contained in this sheet has been supplied by qualified and offer little reduction in the rate of febrile seizure professionals as a guideline for care only. Seek medical advice, as appropriate, recurrence. Your doctor will be able to advise you for concerns regarding your child’s health. about this. 501 Stanley Street w www.childrens.health.qld.gov.au South Brisbane QLD 4101 T: 07 3068 1111 (switch) www.facebook.com/childrenshealthqld.
Load more

Recommended publications
  • Status Epilepticus: Pathophysiology, Epidemiology, and Outcomes
    Arch Dis Child 1998;79:73–77 73 CURRENT TOPIC Arch Dis Child: first published as 10.1136/adc.79.1.73 on 1 July 1998. Downloaded from Status epilepticus: pathophysiology, epidemiology, and outcomes Rod C Scott, Robert A H Surtees, Brian G R Neville Convulsive status epilepticus (CSE) is the most consciousness being regained between the sei- common neurological medical emergency and zures. This gives the impression that status epi- continues to be associated with significant lepticus is always convulsive and is a single morbidity and mortality. Our approach to the entity. There are, however, as many types of epilepsies in childhood has been clarified by the status epilepticus as there are types of seizures, broad separation into benign and malignant and this definition is now probably outdated. syndromes. The factors that suggest a poorer To show that status epilepticus is a complex outcome in terms of seizures, cognition, and disorder, Shorvon has proposed the following behaviour include the presence of multiple sei- definition. Status epilepticus is a disorder in zure types, an additional, particularly cognitive which epileptic activity persists for 30 minutes disability, the presence of identifiable cerebral or more, causing a wide spectrum of clinical pathology, a high rate of seizures, an early age symptoms, and with a highly variable patho- of onset, poor response to antiepileptic drugs, physiological, anatomical, and aetiological and the occurrence of CSE.1 basis.2 CSE needs diVerent definitions for Convulsive status epilepticus is not a syn- diVerent purposes. Many seizures that last for drome in the same sense as febrile convulsions, five minutes will continue for at least 20 benign rolandic epilepsy, and infantile poly- minutes, and so treatment is required for most morphic epilepsy.
    [Show full text]
  • Status Epilepticus: Initial Management
    DATE: July 2018 TEXAS CHILDREN’S HOSPITAL EVIDENCE-BASED OUTCOMES CENTER Initial Management of Status Epilepticus Evidence-Based Guideline Definition: Status Epilepticus (SE) is a disease process Diagnostic Evaluation resulting in prolonged seizures of longer than 5 minutes. (1) The NOTE: Central nervous system (CNS) infection should be cause of SE can stem from the malfunction of the response to excluded. terminate a seizure or from the commencement of the mechanisms that result in prolonged seizures. (2) If SE History: Assess for continues for longer than 30 minutes, there can be permanent Seizure onset neurological damage, including neuronal death, neuronal Known seizure disorder injury, and alteration of neuronal networks. (2,3) Ingestion Fever (e.g., signs of serious infection) Epidemiology: Convulsive status epilepticus (CSE) is the Medications (4) most common neurological emergency seen in childhood. It o Received prior to presentation (e.g., type, dose, is also among the top five reasons for admission to the PICU at dosage, route) Texas Children’s Hospital and is the third most common o Current anticonvulsant medications reason for transport calls. SE is a medical emergency and is o Use of psychopharmacologic medications associated with an overall mortality rate of 8% in children and Toxic/Subtherapeutic anticonvulsant levels (4,5) o 30% in adults. Among children, the overall incidence of SE Nonadherence and/or recent change (4-6) o is approximately 1 to 6 per 10,000/year. The incidence Vagus Nerve Stimulation (VNS) appears to be higher in children under 1 year of age with over Metabolic abnormalities 50% of cases occurring in children under 3 years.
    [Show full text]
  • Is It a Convulsion Or Dopamine Deficiency? a Case of Epilepsy in Dihydropteridine Reductase Deficiency
    Letter to the editor pISSN 2635-909X • eISSN 2635-9103 Ann Child Neurol 2020;28(2):72-74 https://doi.org/10.26815/acn.2019.00304 Is It a Convulsion or Dopamine Deficiency? A Case of Epilepsy in Dihydropteridine Reductase Deficiency Jisu Ryoo, MD, Eun Sook Suh, MD, Jeongho Lee, MD Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea Received: December 20, 2019 Dihydropteridine reductase (DHPR) deficiency A 15-year-old man was admitted to Soon- Revised: February 13, 2020 Accepted: March 2, 2020 is a severe form of hyperphenylalaninemia due chunhyang University Seoul Hospital. At the age to impaired renewal of a substance known as tet- of 3 months, he experienced the first seizure, Corresponding author: rahydrobiopterin (BH4), caused by mutations in characterized by brief psychomotor arrest and Jeongho Lee, MD the quinoid dihydropteridine reductase (QDPR) right hand tremor. He had no family history of Department of Pediatrics, gene [1]. If little or no BH4 is available to facili- seizures or genetic disorders. Brain magnetic res- Soonchunhyang University Seoul tate processing phenylalanine (Phe), this amino onance imaging (MRI) and EEG showed nor- Hospital, Soonchunhyang University College of Medicine, 59 acid can accumulate in the blood and other tis- mal results. The seizures were not controlled by Daesagwan- ro, Yongsan-gu, Seoul sues, and the levels of neurotransmitters (dopa- antiepileptic drugs, including topiramate, val- 04401, Korea mine, serotonin) and the folate in cerebrospinal proate, and lamotrigine; therefore, he discontin- Tel: +82-2-709-9341 fluid also decrease [1]. Symptoms such as mental ued the medication.
    [Show full text]
  • Dictionary of Epilepsy
    DICTIONARY OF EPILEPSY PART I: DEFINITIONS .· DICTIONARY OF EPILEPSY PART I: DEFINITIONS PROFESSOR H. GASTAUT President, University of Aix-Marseilles, France in collaboration with an international group of experts ~ WORLD HEALTH- ORGANIZATION GENEVA 1973 ©World Health Organization 1973 Publications of the World Health Organization enjoy copyright protection in accord­ ance with the provisions of Protocol 2 of the Universal Copyright Convention. For rights of reproduction or translation of WHO publications, in part or in toto, application should be made to the Office of Publications and Translation, World Health Organization, Geneva, Switzerland. The World Health Organization welcomes such applications. PRINTED IN SWITZERLAND WHO WORKING GROUP ON THE DICTIONARY OF EPILEPSY1 Professor R. J. Broughton, Montreal Neurological Institute, Canada Professor H. Collomb, Neuropsychiatric Clinic, University of Dakar, Senegal Professor H. Gastaut, Dean, Joint Faculty of Medicine and Pharmacy, University of Aix-Marseilles, France Professor G. Glaser, Yale University School of Medicine, New Haven, Conn., USA Professor M. Gozzano, Director, Neuropsychiatric Clinic, Rome, Italy Dr A. M. Lorentz de Haas, Epilepsy Centre "Meer en Bosch", Heemstede, Netherlands Professor P. Juhasz, Rector, University of Medical Science, Debrecen, Hungary Professor A. Jus, Chairman, Psychiatric Department, Academy of Medicine, Warsaw, Poland Professor A. Kreindler, Institute of Neurology, Academy of the People's Republic of Romania, Bucharest, Romania Dr J. Kugler, Department of Psychiatry, University of Munich, Federal Republic of Germany Dr H. Landolt, Medical Director, Swiss Institute for Epileptics, Zurich, Switzerland Dr B. A. Lebedev, Chief, Mental Health, WHO, Geneva, Switzerland Dr R. L. Masland, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, USA Professor F.
    [Show full text]
  • Supplementary Table Term* Revised Term** Focal Seizure Without Impairment of a Subjective Sensory Or Psychic Experience As Part of Migraine Or Epilepsy
    Supplementary table Term* Revised term** Focal seizure without impairment of A subjective sensory or psychic experience as part of migraine or epilepsy. In epilepsy it is a focal consciousness or awareness Aura seizure without loss of consciousness (a simple partial seizure). It may or may not be followed by involving subjective sensory or other seizure manifestations. psychic phenomena only Automatic behaviour associated with loss of awareness, such as lip smacking or hand wringing, Automatism Focal dyscognitive seizure occurring as part of a complex partial seizure. Convulsion (previously "grand Tonic-clonic seziure, convulsive Seizure with involuntary, irregular myoclonic, clonic or tonic–clonic movements of one or more mal") seizure limbs. Onset may be focal or primary generalised. Literally ‘already seen’, this refers to a false impression that a present experience is familiar. It is used to refer to something heard, experienced or seen. It can be the aura of a temporal lobe Déjà vu seizure, but also happens in other settings (normal experience, intoxication, migraine, psychiatric). Focal seizure (previously "partial, Focal seizure A seizure originating in a specific cortical location. May be due to a structural lesion. localization related") Literally a ‘blow’. Usually used for an epileptic seizure (but can refer to other paroxysmal events, Ictus such as migraine, transient neurological events and stroke). Similarly pre- and post-ictal are used may for the period before and after a seizure. Idiopathic Genetic In relation to epilepsy, this implies that there is an underlying genetic cause. Literally ‘never seen’, this refers to a false impression that a present experience is unfamiliar. It is Jamais vu used for something seen, heard or experienced.
    [Show full text]
  • What Makes a Simple Partial Seizure Complex.Pdf
    Epilepsy & Behavior 22 (2011) 651–658 Contents lists available at SciVerse ScienceDirect Epilepsy & Behavior journal homepage: www.elsevier.com/locate/yebeh Review What makes a simple partial seizure complex? Andrea E. Cavanna a,b,⁎, Hugh Rickards a, Fizzah Ali a a The Michael Trimble Neuropsychiatry Research Group, Department of Neuropsychiatry, University of Birmingham and BSMHFT, Birmingham, UK b National Hospital for Neurology and Neurosurgery, Institute of Neurology, and UCL, London, UK article info abstract Article history: The assessment of ictal consciousness has been the landmark criterion for the differentiation between simple Received 26 September 2011 and complex partial seizures over the last three decades. After review of the historical development of the Accepted 2 October 2011 concept of “complex partial seizure,” the difficulties surrounding the simple versus complex dichotomy are Available online 13 November 2011 addressed from theoretical, phenomenological, and neurophysiological standpoints. With respect to con- sciousness, careful analysis of ictal semiology shows that both the general level of vigilance and the specific Keywords: contents of the conscious state can be selectively involved during partial seizures. Moreover, recent neuroim- Epilepsy fi Complex partial seizures aging ndings, coupled with classic electrophysiological studies, suggest that the neural substrate of ictal Consciousness alterations of consciousness is twofold: focal hyperactivity in the limbic structures generates the complex Experiential phenomena psychic phenomena responsible for the altered contents of consciousness, and secondary disruption of the Limbic system network involving the thalamus and the frontoparietal association cortices affects the level of awareness. These data, along with the localization information they provide, should be taken into account in the formu- lation of new criteria for the classification of seizures with focal onset.
    [Show full text]
  • Epilepsy & My Child Toolkit
    Epilepsy & My Child Toolkit A Resource for Parents with a Newly Diagnosed Child 136EMC Epilepsy & My Child Toolkit A Resource for Parents with a Newly Diagnosed Child “Obstacles are the things we see when we take our eyes off our goals.” -Zig Ziglar EPILEPSY & MY CHILD TOOLKIT • TABLE OF CONTENTS Introduction Purpose .............................................................................................................................................5 How to Use This Toolkit ....................................................................................................................5 About Epilepsy What is Epilepsy? ..............................................................................................................................7 What is a Seizure? .............................................................................................................................8 Myths & Facts ...................................................................................................................................8 How is Epilepsy Diagnosed? ............................................................................................................9 How is Epilepsy Treated? ..................................................................................................................10 Managing Epilepsy How Can You Help Manage Your Child’s Care? ...............................................................................13 What Should You Do if Your Child has a Seizure? ............................................................................14
    [Show full text]
  • Clinical Decision Making in Seizures and Status Epilepticus
    January 2015 Clinical Decision Making Volume 17, Number 1 Authors In Seizures And Felipe Teran, MD Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Faculty, Emergency Department, Clínica Status Epilepticus Alemana, Santiago, Chile Katrina Harper-Kirksey, MD Abstract Anesthesia Critical Care Fellow, Department of Anesthesia, Stanford Hospital and Clinics, Stanford, CA Andy Jagoda, MD, FACEP Seizures and status epilepticus are frequent neurologic emergen- Professor and Chair, Department of Emergency Medicine, Icahn cies in the emergency department, accounting for 1% of all emer- School of Medicine at Mount Sinai, New York, NY; Medical Director, Mount Sinai Hospital, New York, NY gency department visits. The management of this time-sensitive and potentially life-threatening condition is challenging for both Peer Reviewers prehospital providers and emergency clinicians. The approach to J. Stephen Huff, MD Professor of Emergency Medicine and Neurology, University of seizing patients begins with differentiating seizure activity from Virginia, Charlottesville, VA mimics and follows with identifying potential secondary etiolo- Jason McMullan, MD gies, such as alcohol-related seizures. The approach to the patient Assistant Professor, Department of Emergency Medicine, University of in status epilepticus and the patient with nonconvulsive status Cincinnati, Cincinnati, OH epilepticus constitutes a special clinical challenge. This review CME Objectives summarizes the best available evidence and recommendations Upon completion of this article, you should be able to: regarding diagnosis and resuscitation of the seizing patient in the 1. Describe the diagnostic approach to patients who have recovered from a seizure and patients in status epilepticus. emergency setting. 2. Recognize and treat patients with alcohol withdrawal seizures.
    [Show full text]
  • Electroencephalogram Abnormality and High-Dose Busulfan in Conditioning Regimens for Stem Cell Transplantation
    Bone Marrow Transplantation, (1998) 21, 217–220 1998 Stockton Press All rights reserved 0268–3369/98 $12.00 Electroencephalogram abnormality and high-dose busulfan in conditioning regimens for stem cell transplantation R Kobayashi, N Watanabe, A Iguchi, Y Cho, M Yoshida, H Arioka, H Naito, T Shikano and Y Ishikawa Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan Summary: Patients and methods High-dose busulfan (BU) is widely used in combined Between June 1989 and November 1996, a total of 22 chemotherapy before allogeneic or autologous bone patients with various hematological malignancies or marrow transplantation. Convulsions are reported as a immunodeficiencies received allogeneic BMT (14 cases) or side-effect of high-dose BU. We recorded electroence- autologous peripheral blood stem cell transplants (eight phalograms (EEGs) before and on the third day of BU cases) after preparation with high-dose BU (Table 1). Thir- administration in 22 patients. Abnormal EEGs were teen patients had acute lymphoblastic leukemia (ALL): observed on the third day in 13 cases (59%). These eight were in first complete remission (CR) and five were patients were older (P , 0.05) and had had larger doses in second CR. Five patients had acute non-lymphoblastic of BU (P , 0.025) than the nine patients with normal leukemia (ANLL): three were in first CR and two were EEGs. Convulsions occurred in two of the 22 patients, in second CR. Five patients had other diseases: two non- one of whom was receiving prophylaxis with phenytoin. Hodgkin’s lymphoma (NHL), one Wiskott Aldrich syn- Gamma aminobutyric acid (GABA), a natural mediator drome (WAS), and one chronic myelogenous leukemia of defense against epileptic activity, concentrations in (CML).
    [Show full text]
  • Febrile Convulsions
    Febrile convulsions What is a febrile convulsion? move the child unless the seizure occurs in a hazardous area e.g. the bath or pool. A febrile convulsion (also known as a febrile seizure) is Place something soft under your child’s head to stop common. Approximately 3% of children aged 6 months to their head hitting the floor. 6 years may have a convulsion when they have a fever or Roll your child onto their side. This is also known as the high temperature. recovery position. If there is food in their mouth turn A convulsion is caused by a short burst of abnormal their head to the side, do not try to remove it. electrical activity in the brain. This is when the nerve Unless you are giving your child emergency medication cells send “mixed-up” signals to each other. These (such as midazolam), never put anything in the mouth mixed-up signals may lead to a change in the child’s of your child – it is impossible for your child to swallow awareness or body movement. Sometimes people use their tongue other names for convulsions such as fits or seizures. Your child may become tired after the seizure. Allow What causes a febrile convulsion? them to rest and recover. The febrile convulsion or seizure happens when the normal brain activity is disturbed by a fever. It usually happens without warning. During the seizure your child Should I call an ambulance? may: Call 000 for an ambulance if: become stiff or floppy, you feel worried. stare unresponsively, become unconscious or unaware it is your child’s first seizure.
    [Show full text]
  • Epileptic Dizziness
    BRITISH MEDICAL JOURNAL VOLUME 282 28 FEBRUARY 1981 687 Br Med J (Clin Res Ed): first published as 10.1136/bmj.282.6265.687 on 28 February 1981. Downloaded from PAPERS AND SHORT REPORTS Epileptic dizziness J KOGEORGOS, D F SCOTT, M SWASH Abstract disequilibrium, with or without a feeling of rotation, was the sole or main reason for referral. In all patients investigation and the Clinical and electroencephalographic features and the results of treatment indicated that the dizziness was due to epilepsy response to treatment of 30 patients with episodic rather than any other disorder. Twenty-four patients were referred dizziness due to epilepsy were noted. The symptom direct by their general practitioners, three from the ear, nose, and consisted of a brief episode of disequilibrium, often with throat clinic at this hospital, and three by other doctors. Patients in a sensation of rotation, without evident precipitating whom dizziness was not the predominant symptom were excluded, factors or sequelae. as were those older than 65 years, those with a history of cerebral vascular disease, and those with symptoms of middle-ear disease. A history of "absences" or other features suggestive Each patient's assessment was based on the history and examination of temporal lobe epilepsy was elicited in over half the results, but all underwent otological and electroencephalographic patients, and seven (almost a quarter) had had one or assessments. The otological assessment consisted of clinical, audio- more generalised seizures before presentation. Electro- metric, and caloric tests. Radiological investigations, including encephalography showed a posterior temporal lobe focus radioisotopic scanning or computed tomography of the head, were in all but two patients, and there was a family history of carried out in five patients.
    [Show full text]
  • Focal Seizures Due to Chronic Localized Encephalitis
    Focal seizures due to chronic localized encephalitis Theodore Rasmussen, M.D., Jerzy Olszewski, M.D.' and Donald Lloyd-Smith, M.D. OCCASIONALSPECIMENS of scarred, atrophic Remooal of the left frontal lobe, carded out six brain removed for the relief of focal cerebral months after the onset of seizures in a fruitless at- seizures at the Montreal Neurological Institute tempt to stop them, proofded an oppoctunity to compare the miczoscopic picture at that time with have shown striking perivascular collections that shown at autopsy three and a half months of round cells, particularly in less severely later. damaged areas of these specimens. In the past Birth and early development of this child were this perivascular cuffing has been attributed normal, and there were no signscant illnesses until April 1955 at 18 months of age, when the parents to the effect on the brain of recurring seiz- noted a scratch behind the right ear. The follow- ures, with recognition, however, that this was ing day swelling in this region was noted and the a rather unsatisfactory explanation since the temperature rose to 104" F. The tempefature sub- great majority of surgical specimens removed sided the next day after administration of penicil- from patients with equally frequent focal seiz- lin, but the swelling behind the ear continued to discharge bloody fluid for one week. ures do not show this change. Histologic The child seemed entirely well for two months, studies of surgical specimens from three chil- but in July he became unusually irritable one day dren recently operated upon for intractable and vomited the followin mornin .
    [Show full text]