Febrile Convulsions
This is the most common form of seizures in the pediatric age group. This is also, one of the common reasons parents run to emergency rooms.
These are seizures associated with fever but without evidence of intracranial infections or definite cause. The usual age of onset is between 6 months to 4 years. The seizure is described as generalized, short in duration with a short postictal phase and a normal neurologic and EEG examinations.
One of the pillars of the Pediatric Neurologist in the Philippines, Dr. Rhandy Pe Benito, once said and I quote, ” if you are on duty and you are called to the ER because of a febrile child with convulsion, continue what you are doing in the ward, comb your hair, put on lipstick, go to ER by the staircase and not by elevator, so upon reaching ER, the convulsion is gone.” With this statement, Dr. Pe Benito is trying to convey to us that this kind of seizure is not something serious.
As pediatricians, we have to do complete history, physical and neurological examination on the patient. Blood samples are taken and some will have lumbar puncture if a CNS infection is suspected.
The two significant risks associated with febrile seizures are:1. Risk of recurrent febrile seizure2. Increased risk of later epilepsy
There is no evidence of mental or neurological impairment noted.
In cases of febrile seizures, we usually advise parents and caretakers on the management of fever like giving of antipyretic medications, doing sponge bath using ordinary tap water with no ice and no alcohol and bringing the child for check up to assess the problem.