Febrile convulsion

Definition:

• Febrile convulsions, also known as febrile seizures, are convulsions associated with a high body temperature (fever), but without an underlying central nervous system infection. They are the most common type of seizures in children.

Epidemiology:

• Typically occur in children between the ages of 6 months and 5 years.
• There is a slight male predominance.

Etiology:

• The exact cause is unknown, but they are thought to be related to the rapid increase in body temperature rather than the absolute value of the fever.
• Often occur with common childhood illnesses like ear infections, colds, and viral infections.

Classification:

1. Simple Febrile Convulsions:
   • More common.
   • Generalized seizure lasting less than 15 minutes.
   • Does not recur within 24 hours or a febrile illness.
2. Complex Febrile Convulsions:
   • Last longer than 15 minutes, occur more than once during a febrile illness, or are focal in nature.

Clinical Features:

• Seizure occurring in the context of a febrile illness.
• Loss of consciousness and convulsions (jerking movements).
• Postictal drowsiness or confusion may follow.

Diagnosis:

• Clinical diagnosis based on history and presentation.
• Exclusion of central nervous system infection (e.g., meningitis) is crucial, especially in complex cases or if there are any atypical features.
• Lumbar puncture may be required in certain cases to rule out meningitis, especially in infants.

Management:

• Treatment is directed at the febrile illness and maintaining safety during seizures.
• Antipyretics can be used to control fever.
• Antiepileptic drugs are generally not recommended for simple febrile convulsions.
• Parental education about managing future seizures and when to seek medical attention.

Prognosis:

• Generally good, with most children outgrowing the tendency to have febrile convulsions by the age of 5.
• Simple febrile convulsions do not cause brain damage and have a low risk of developing into epilepsy.