Febrile convulsions in children

Febrile, or temperature, convulsions are called convulsive (convulsive) seizures, which occur as a reaction to increased body temperature (usually above 380C) in children under 6 years of age, with the obligatory condition of absence of seizures without fever.

Such cramps are more common in children from 6 to 18 months. life. According to statistics, about 5% of children under 6 years old are prone to febrile seizures. The duration of the attack can be up to 15 minutes.

Such seizures are not epilepsy - a disease that can affect children of any age. If convulsions occur in children older than 6 years, or the duration of convulsions exceeds 15 minutes, a thorough examination is necessary to exclude childhood epilepsy.

Content

1Causes of temperature convulsions
2Types and Symptoms of Febrile Seizures
3Examination of children with temperature cramps
4Treatment
5Resume for parents

Causes of temperature convulsions

The causes and mechanism of the development of convulsions against the background of hyperthermia is not fully understood.

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Experts believe that the main role in their occurrence is played by the immaturity of the central nervous system, the inhibition processes in which are weakened.

The center of thermoregulation is also immature. For this reason, the excitement that has arisen in this center is freely transmitted, spreads between the cells in the brain and causes a convulsive contraction of the muscles.

Such a reaction in the brain develops regardless of the cause of the elevated temperature: viral or bacterial infection, postvaccinal reaction, etc. As the central nervous system matures (by the age of 6), temperature cramps stop.

Hereditary predisposition also has significance: in the presence of epilepsy in close relatives of the child the probability of occurrence of temperature convulsions is higher.

Types and Symptoms of Febrile Seizures

If the temperature is usually marked reddening of hot skin, then before a convulsive fit there is a sharp pallor of the skin, sometimes with a bluish tinge. The baby's calf is covered with a sticky sweat.

Distinguish between tonic, atonic and local convulsions, let's talk about each species in more detail:

With tonic convulsions, the child's body stretches out, the head tilts back, eyes are rolled up, teeth are tightly compressed, foam is released on the blue lips. The legs of the toddler are strained and straightened, the knobs are bent and pressed to the chest.

There is a shortage of air to the baby. There may be a loss of consciousness. Noticeable rhythmic twitching of large muscles. Gradually flinches or muscle twitches become less frequent and completely cease.

Atonic cramps are characterized by maximum relaxation of the muscles of the whole body. Involuntary urination and defecation occur.

With local convulsions, jerking of the limb muscles (upper or lower) appears, eyes are rolled up.

With any kind of convulsions, the child becomes inhibited, does not respond to speech and the actions of an adult, there comes a kind of numbness. Loses contact with others. The baby does not cry, because of the delay in breathing, there is a cyanotic shade of the skin.

Duration of seizure from 30 seconds. up to several minutes (usually 2-5 minutes). It is important to help and to stop the convulsive syndrome as soon as possible. The longer the seizure lasts, the more dangerous the consequences may be.

Febrile seizures can develop one after another. In many children (30%) they develop repeatedly at any temperature increase.

After cupping or self-termination of an episode of seizures, the child is sluggish, drowsy, hardly able to navigate in space, does not remember what happened.

Examination of children with temperature cramps

If there is a seizure in a child, even a single one, an examination of the child neurologist is necessary to exclude epilepsy and other causes of seizures.

In addition to the examination, the doctor may prescribe an additional study:

clinical examination of blood, urine;
a blood test for calcium content (assigned to infants to avoid spasmophilia);
electroencephalography;
CT or MRI of the brain.

In some cases (with suspicion of meningoencephalitis in the child) a spinal puncture is performed followed by a study of the CSF.

Treatment

It is impossible to stop the already begun attack of seizures. It is necessary to immediately call an ambulance, and before the brigade arrives, take the necessary measures to prevent injury to the baby.

For first aid:

put the baby on a flat surface, remove those items that could injure him;
Do not try to unclench your child's teeth and put something in your mouth;
remove close clothing;
turn the child to the left side to improve the air supply to the respiratory tract;
provide fresh air into the room and achieve the optimum room temperature (+ 200C);
with the purpose of lowering the body temperature, the baby needs to insert a febrifugal candle with Paracetamol (watering the child with antipyretic medicines during an attack can not be!);
at a very high temperature, you can wipe the body with a half-alcohol solution, vinegar, diluted water or just water;
to lower the temperature, also applies the application of cold to the carotid (in the neck) or the femoral artery (in the groin fold);
when breathing is stopped, take measures for reflex recovery: moisten a cotton swab with ammonia and bring it to the baby's nose; sprinkle the child with cold water;
if the breathing has not recovered, then at the end of the seizure, it is necessary to start artificial respiration (on a background of cramps it is ineffective), the skills of which should be enjoyed by all parents.

If the baby's febrile convulsions are short-term (less than 15 minutes) and occur very rarely, then, as a rule, special treatment is not prescribed. In order to prevent the development of seizures, it is necessary to give the child antipyretic agents at any temperature even at 37.5 ° C.

Febrile convulsions in children With longer or more frequent convulsions, anticonvulsant treatment can be performed, but only according to the appointment of a neurologist. Children are more often prescribed phenytoin, phenobarbital, valproic acid.

Resume for parents

You can not panic when developing convulsions in crumbs at elevated temperature. We must immediately call an "ambulance" and begin to provide the baby with first or urgent help. Properly provided care will prevent the development of negative consequences after seizures.

The consultation of a pediatric neurologist is mandatory in these cases to exclude another cause of convulsive seizure and to provide the child with (if necessary) anticonvulsant treatment. The likelihood of epilepsy in a child with temperature seizures is 2%.

Pediatrician E.O. Komarovsky about febrile convulsions in children:

Febrile convulsions in the child: what to do? - Doctor Komarovsky