Febrile seizure
Seizure associated with high body temperature / From Wikipedia, the free encyclopedia
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A febrile seizure, also known as a fever fit or febrile convulsion, is a seizure associated with a high body temperature but without any serious underlying health issue.[1] They most commonly occur in children between the ages of 6 months and 5 years.[1][3] Most seizures are less than five minutes in duration, and the child is completely back to normal within an hour of the event.[1][4] There are two types: simple febrile seizures and complex febrile seizures.[1] Simple febrile seizures involve an otherwise healthy child who has at most one tonic-clonic seizure lasting less than 15 minutes in a 24-hour period.[1] Complex febrile seizures have focal symptoms, last longer than 15 minutes, or occur more than once within 24 hours.[5] About 80% are classified as simple febrile seizures.[6]
Febrile seizure | |
---|---|
Other names | Fever fit, febrile convulsion |
An analog medical thermometer showing a temperature of 38.8 °C or 101.8 °F | |
Specialty | Emergency medicine, neurology |
Symptoms | Tonic-clonic seizure[1] |
Usual onset | Ages of 6 months to 5 years[1] |
Duration | Typically less than 5 minutes[1] |
Types | Simple, complex[1] |
Causes | High body temperature[1] |
Risk factors | Family history[1] |
Differential diagnosis | Meningitis, metabolic disorders[1] |
Treatment | Supportive care[1] |
Medication | Benzodiazepines (rarely needed)[1] |
Prognosis | Good[1] |
Frequency | ~5% of children[2] |
Febrile seizures are triggered by fever, typically due to a viral infection.[6] They may run in families.[1] The underlying mechanism is not fully known, but it is thought to involve genetics, environmental factors, brain immaturity, and inflammatory mediators.[7][8][6] The diagnosis involves verifying that there is not an infection of the brain, there are no metabolic problems, and there have not been prior seizures that have occurred without a fever.[1][6] Blood testing, imaging of the brain, or an electroencephalogram (EEG) is typically not needed.[1] Examination to determine the source of the fever is recommended.[1][6] In otherwise healthy-looking children a lumbar puncture is not necessarily required.[1]
Neither anti-seizure medication nor anti-fever medication are recommended in an effort to prevent further simple febrile seizures.[1][9] In the few cases that last greater than 5 minutes, a benzodiazepine such as lorazepam or midazolam may be used.[1][10] Efforts to rapidly cool during a seizure is not recommended.[11]
Febrile seizures affect 2–10% of children.[2] They are more common in boys than girls.[12] After a single febrile seizure there is an approximately 35% chance of having another one during childhood.[6] Outcomes are generally excellent with similar academic achievements to other children and no change in the risk of death for those with simple seizures.[1] There is tentative evidence that affected children have a slightly increased risk of epilepsy at 2% compared to the general population.[1]