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Concept
Febrile seizure
Summary
A febrile seizure, also known as a fever fit or febrile convulsion, is a seizure associated with a high body temperature but without any serious underlying health issue. They most commonly occur in children between the ages of 6 months and 5 years. Most seizures are less than five minutes in duration, and the child is completely back to normal within an hour of the event. There are two types: simple febrile seizures and complex febrile seizures. Simple febrile seizures involve an otherwise healthy child who has at most one tonic-clonic seizure lasting less than 15 minutes in a 24-hour period. Complex febrile seizures have focal symptoms, last longer than 15 minutes, or occur more than once within 24 hours. About 80% are classified as simple febrile seizures.
Febrile seizures are triggered by fever, typically due to a viral infection. They may run in families. The underlying mechanism is not fully known, but it is thought to involve genetics, environmental factors, brain immaturity, and inflammatory mediators. The diagnosis involves verifying that there is not an infection of the brain, there are no metabolic problems, and there have not been prior seizures that have occurred without a fever. Blood testing, imaging of the brain, or an electroencephalogram (EEG) is typically not needed. Examination to determine the source of the fever is recommended. In otherwise healthy-looking children a lumbar puncture is not necessarily required.
Neither anti-seizure medication nor anti-fever medication are recommended in an effort to prevent further simple febrile seizures. In the few cases that last greater than 5 minutes, a benzodiazepine such as lorazepam or midazolam may be used. Efforts to rapidly cool during a seizure is not recommended.
Febrile seizures affect 2–10% of children. They are more common in boys than girls. After a single febrile seizure there is an approximately 35% chance of having another one during childhood. Outcomes are generally excellent with similar academic achievements to other children and no change in the risk of death for those with simple seizures.
Official source
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