The moment a child has convulsions, parents press the panic button, and pass on their anxiety to the doctor and the attending staff as well. Individual susceptibility to febrile fits depends on transmission of specific trait, mosquitoes bite all of us, a few get malaria, and a few filariasis but on some it has no effect!!
Dr.K.Pandian, Consultant Paediatric Neurologist, explains…
What is Febrile Fits?
Occurrence of convulsions with fever without any infection of the brain is termed febrile fits. Some children who experience a sudden rise in temperature tend to have convulsions. An otherwise normal child with minor respiratory infection or an insignificant illness, rolls the eyes, suddenly looks upwards, and becomes unresponsive. In some, this progresses to twitching of the lips and frothing from the mouth. The child may have either stiffening of all the limbs or twitching of the hands and legs. Usually this lasts for a few seconds or minutes and almost invariably self limiting. In a few instances this may get prolonged over 15 minutes.
When does it occur?
Children have convulsions even with a slight increase in body temperature. Normally there are no episodes after the second day. But if there is a repeat attack, investigations have to be done to rule out other serious causes.
What is the age when it can occur?
Convulsions occur in children in the age group of 6 months to five years of age. Convulsions are more common in boys than girls, but chances of epilepsy must be ruled out.
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Why does it occur?
In some children, the threshold of the brain, resists a sudden rise in temperature which makes them susceptible to fits.
What are the types of fits?
Usually a febrile fit is brief and generalized, i.e., it affects both sides of the body is self-limiting and the child usually regains full senses after the episode. If it does not produce any after affects like paralysis, unresponsiveness or weakness it is simple febrile fits.
On the other hand if it lasts more than few minutes or continues for 15 – 30 minutes affecting one side of the body, producing profound unresponsiveness, it is termed as complex febrile fits.
What is the natural course of illness?
Usually it is self-limiting. By the time medical help are sought most of the fits subside.
Will there be repercussions later?
Children who have febrile fits have strong tendency to have recurrence till around 6 years of age. The risk is high in smaller children, in those with family history and in those with already existing developmental or neurological problem.
Can febrile fits damage the brain?
Brief seizures do not. But convulsions lasting 20 minutes and a ve can damage the brain. Some may develop damage to a particular area of brain, which may lead to epilepsy later.
Why does it occur in only some? Is it hereditary?
Individual susceptibility to febrile fits depends on transmission of specific trait.
In most cases there is a history of similar febrile fits in the parent or the siblings. But a definite correlate is still not proven.
Can febrile fits be prevented?
- Yes. With a child prone to febrile fits, never allow temperature to shoot up.
- Start medications like paracetamol in the dose advised by your doctor.
- It is wrong to keep the child wrapped in blanket as this prevents heat loss.
- Sponging with water from head to foot helps to bring down temperature.
- Certain drugs like diazepam, clobazam given orally along with paracetamol largely reduce the incidence of fits.
Do’ s and Don’ts in case of febrile fits
Do’s
- Remove all tight clothing
- Make the child lie on its side on a flat surface with out a pillow. This will help secretions to drool out
- Keep the child under a fan or in a well- ventilated place
- Gently tap the back and wipe out all secretions
- Sponging the child with tap water (if there is any nowadays!!) will help bring down the temperature
- Try rectal drugs if trained.
- If the fits do not subside within few minutes call for medical help
- Seek medical attention always, as you should not miss a serious infection of the brain
Don’ts
- Do not panic.
- Do not try to insert anything in between the teeth or try to put your finger.
- Do not try to toss from shoulder to shoulder as the child may choke in its own secretions.
- Do not try to give anything by mouth especially drugs.
Above all it is essential to treat the child as normal, being overprotective or tense, may affect the child psychologically.
Pic courtesy: abbott.in