Febrile seizure
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| ICD-10 | R56.0 |
|---|---|
| ICD-9 | 780.31 |
| OMIM | 604352 |
| DiseasesDB | 4777 |
| MedlinePlus | 000980 |
| eMedicine | neuro/134 |
| MeSH | D003294 |
A febrile seizure', also known as a fever fit or febrile convulsion is a convulsion triggered by a rise in body temperature. They most commonly occur in children between the ages of 6 months and 3 years and are twice as common in boys than girls. [1] The direct cause of a febrile seizure is not certain; however, it is normally precipitated by a recent upper respiratory infection or gastroenteritis. A febrile seizure is the effect of a sudden rise in temperature, 102.0 or higher, rather than a fever that has been present for a prolonged length of time.[1]
Febrile seizures represent the meeting point between a low seizure threshold (genetically and age determined) - some children have a greater tendency to have a seizure under certain circumstances - and a trigger: fever. The genetic causes of febrile seizures are still being researched. Some mutations that cause a neuronal hyperexcitability and could be responsible for febrile seizures have already been discovered[citation needed].
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[edit] Diagnosis
The diagnosis is one that must be arrived at by eliminating more serious causes of seizure and fever: in particular, meningitis and encephalitis must be ruled out. Therefore a doctor's opinion should be sought and in many cases the child would be admitted to hospital overnight for observation and/or tests. As a general rule, if the child returns to a normal state of health soon after the seizure, a nervous system infection is unlikely. Even in cases where the diagnosis is febrile seizure, doctors will try to identify and treat the source of fever.
[edit] Types
There are two types of febrile seizures. A simple febrile seizure is one in which the seizure lasts less than 15 minutes, does not recur in the next 24 hours, and involves the entire body (classically a generalized tonic-clonic seizure). A complex febrile seizure is characterized by longer duration, recurrence, or focus on only part of the body. The simple seizure represents the majority of cases and is considered to be less of a cause for concern than the complex[citation needed].
Simple febrile seizures generally do not cause permanent brain injury; do not tend to recur frequently, as children tend to 'out-grow' them; and do not make the development of adult epilepsy significantly more likely (less than 3-5% which is similar to that of the general public)[citation needed]. Children with febrile convulsions are more likely to suffer from afebrile epileptic attacks in the future if they have a complex febrile seizure, a family history of afebrile convulsions in first degree relatives (a parent or sibling), or a pre-convulsion history of abnormal neurological signs or developmental delay. Similarly, the prognosis after a simple febrile seizure is excellent, whereas an increased risk of death has been shown for complex febrile seizures (partly related to underlying conditions).[2]
[edit] Treatment
When anticonvulsant therapy is judged by a doctor to be indicated anticonvulsants can be prescribed. Sodium valproate or clonazepam are active against febrile seizures with sodium valproate showing superiority over clonazepam.[3]
[edit] Symptoms
During simple febrile seizures, the body will become stiff and the arms and legs will begin twitching. The patient may lose consciousness and possibly wet or soil themselves. They may also vomit and foam at the mouth. The seizure normally lasts for less than five minutes[4].
[edit] Footnotes
- ^ a b Snider, Kathleen. ATI NurseNotes: Pediatrics (117) Overland Park: Lippincott Raven Publishers, 1998.
- ^ Vestergaard M, Pedersen MG, Ostergaard JR, Pedersen CB, Olsen J, Christensen J (August 2008). "Death in children with febrile seizures: a population-based cohort study". Lancet 372 (9637): 457–63. doi:. PMID 18692714. http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(08)61198-8.
- ^ Steardo L, Florio C, Sorge F, Steardo R (June 1980). "[DPA and clonazepam activity in febrile convulsions: preliminary results]" (in Italian). Boll. Soc. Ital. Biol. Sper. 56 (11): 1187–91. PMID 6255970.
- ^ http://www.nhs.uk/Conditions/Febrile-convulsions/Pages/Symptoms.aspx
[edit] References
- Wilkinson, I.M.S. Neurology. Blackwell Science. ISBN 0-86542-854-9
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