Do not panic if you have a febrile convulsion

Febrile convulsion in children: do not panic!

03/10/2014

For parents, it is usually a shock when they see, when their child in a fever suddenly twitching all over, the eyes twisted and unresponsive. Particularly dramatic is that it often hits the very young, who have just outgrown the infancy. But experts say, this is no reason to panic.

Terrifying sight for parents
Not only for parents, it is a frightening sight when a child with a fever suddenly turns his eyes, stops responding and writhes in convulsions. When it comes to toddlers, however, there is often a febrile spasm behind it and it is usually harmless. The guardians should therefore not panic. Dr. Claudia Nußbaum, a doctor at the Hauner children's hospital in Munich can understand the fears of the parents and so she said according to press reports: „For them, such a fit is very scary.“ This is how Dr. Ingo Borggräfe, Senior Physician for Neuropediatrics and Head of the Department of Pediatric Epileptology of the Epilepsy Center of Ludwig-Maximillians-Universität München: „Most people think that is life threatening.“

At the first febrile convulsion call doctor or to the clinic
However, epilepsy is rarely found when infants have fever and have a seizure with muscle twitching. Very often it is a febrile convulsion. „Such a life-threatening is almost never“, so Borggräfe. Especially in the winter months, when especially many children have a cold, the number of people affected increases. Most of these are children who are at least six months old, but not older than five years. Of the children at this age, about two to five percent are affected by febrile seizures. According to Borggräfe, the age peak is 18 months. Although these cramps are almost always harmless, the expert advises parents to call a doctor or drive the child to the nearest clinic when a febrile convulsion first occurs. This is because, although an elevated temperature is very often the trigger of the attack, but could also be behind other causes that are associated with fever and need to be treated quickly. For example, meningitis could trigger a seizure.

Antipyretic means do not prevent febrile convulsion
A doctor can usually rule out such an inflammation on the basis of the symptoms and the circumstances of the seizure and therefore an examination of the nerve water is usually not necessary. Much more often parents fear in a febrile convulsion of their child anyway, that it could be epilepsy. However, as Borggräfe says, that is almost never the cause. The suspicion can also clarify in the rare cases in which there is an indication, with an electroencephalogram (EEG). Doctors will usually release children quickly if both epilepsy and meningitis have been ruled out. Above all, it is limited to finding the cause of the fever. For example, if there is a bacterial infection, such as the middle ear, respiratory or urinary tract, it is treated with antibiotics. However, it can not be prevented that it comes again to a fever spasm, not even with fever-reducing agents, said Borggräfe. However, it is recommended to take antipyretic measures in case of an infection in order to promote the well-being of the child.

In case of seizure, bring children into stable lateral position
It is especially important for parents to know how to deal with a febrile convulsion. You should bring your child then in the stable side position as possible „or at least turn to the side“, like Dr. Nussbaum explained. This as a safety measure in case it breaks. Above all, parents should not try to put something between their teeth, as sometimes seen on television. This is dangerous because it can cause damage to the teeth or because children could inhale smaller items, so the doctor. In addition, one should not try to infuse fluid into his child. Even if a seizure usually stops by itself after a few minutes, parents should look at the clock right at the beginning. If a febrile convulsion takes a long time, an emergency doctor should stop the attack with a drug. Seizures that last longer than fifteen minutes or repeat within 24 hours are considered to be complicated.

Children lose seizure propensity over the years
The reason why it hits especially the little ones so often, is probably at the stage of development in which their brain is in this stage of life. The healthy balance of messenger substances is particularly mixed up in children aged six months to five years. In addition, fever made the brain more susceptible to seizure, Borggräfe explained. If both come together, it can trigger a febrile convulsion. The investment probably plays a role. „Febrile convulsions occur frequently in some families“, so nut tree. In about 20 percent of cases, the sibling also experiences a febrile convulsion when a child is already affected. For identical twins, the probability is even around 50 percent. Parents should expect that their child will suffer a renewed seizure, if this was the case. At least that's the case with about every third child. But the child will lose this tendency to seizure as it gets older. In addition, as Borggräfe calms down, the worry that brain cells will die off in a new attack and that the child may even be left behind in his mental development is unfounded.

Vaccination does not trigger febrile convulsion
Dr. Nussbaum also stated that vaccination was not the cause of a seizure. This against the background that some parents have a vaccine as a trigger in suspicion, since especially in infancy much vaccination pending. At most indirectly, a vaccine could lead to a febrile convulsion because some children react to it with fever, which in turn could trigger a seizure. „But not the vaccine itself“, as Nussbaum explained. Even if parents can not prevent a new fever convulsion, they still have the option of having at least one emergency remedy available if the attack lasts more than a few minutes. It is approved for use in febrile seizures only a drug in the form of a rectal, which is introduced like an enema into the anus. As Borggräfe said, this is often difficult or impossible during a seizure. Therefore, there is also an agent that is dripped into the mouth via plastic syringe and absorbed through the mucous membrane. However, this is formally only approved for children with epilepsy and not in febrile convulsions. (Sb)