FEBRILE SEIZURE/FEVER CONVULSIONS OR FEBRILE NEUTROPENIA

Fever convulsions (febrile seizures) are uncontrolled muscle spasms that can happen while a child's tempera­ture is rapidly rising (sometimes the convulsion occurs before you are even aware that the child has a fever). Once a child's fever has reached a high temperature, the risk of a convulsion is probably over.

The danger of an extremely high temperature is the possibility that the fever will cause a seizure (convulsion). All of us are capable of "seizing" if pour body temperature become too high. Febrile seizures are relatively common in normal, healthy children: about 3 to 5 percent will experience a febrile seizure. However, although common, they must be treated with respect.

Febrile seizures occur most often in children between the ages of six months and four years. Illness that cause rapid elevations to high temperatures, such as roseola, have been frequently associated with febrile seizures. Rarely, a seizure is the first sign of a serious underlying problem such as meningitis.

The brain, which is normally transmitting electrical impulses at a fairly regular rhythm, begins misfiring during a seizure because of overheating and causes involuntary muscular responses, termed a seizure, convulsion, fit, or "falling out spell."

SYMPTOMS OF FEBRILE SEIZURE/ FEVER CONVULSIONS OR FEBRILE NEUTROPENIA

The first sign may be a stiffening of entire body. Children may have rhythmic beating of a single hand or foot, or any combination of the hands and feet. The eyes may roll back and the head may jerk. Urine and feces may pass involuntarily.

A child who is having a fever con­vulsion will lose consciousness. The child's muscles will stiffen, and his or her teeth will clench. Then the child's arms and legs will start to jerk. The child's eyes may roll back, and he or she may stop breathing for a few seconds. The child might also vomit, urinate, or pass stools.

Most seizures last only from 1 to 5 minutes. There is very little evidence that a short seizure is of any long- term consequence On the other hand, prolonged seizures of more than 30 minutes are often a sign of more serious underlying problem. Less than half of all children who have short seizure will ever experience a second, and less than half who experience a second will have a third.

CAUSES OF FEBRILE SEIZURE/ FEVER CONVULSION OR FEBRILE NEUTROPENIA

About 3 to 5 percent of otherwise healthy children between the ages of 9 months and 5 years will have a seizure caused by a fever. Toddlers are most commonly affected. There is a tendency for febrile seizures to run in families. Most febrile seizures are triggered by a rapid rise of body temperature over 102.2 degrees F. Most occur well within the first 24 hours of an illness, not necessarily when the fever is highest. The seizure is often the first sign of a fever.

The first febrile seizure is usually one of life's most frightening moments for parents. Most parents are afraid that their child will die or have brain damage. Thankfully, simple febrile seizures are harmless. There is no evidence that simple febrile seizures cause death, brain damage, epilepsy, mental retardation, a decrease in IQ, or learning difficulties.

Most febrile seizures are triggered by fevers from viral upper respiratory infections, ear infections, or roseola. Meningitis causes less than 0.1 percent of febrile seizures but should ALWAYS be considered, especially in children less than one year old or those who still look ill when the fever drops.

A simple febrile seizure stops by itself within a few seconds to 10 minutes, usually followed by a brief period of drowsiness or confusion. Anticonvulsant medicines are generally not needed.

A complex febrile seizure is one that lasts longer than 15 minutes, occurs in an isolated part of the body, or recurs during the same illness.

About a third of children who have had a febrile seizure will have another one with a subsequent fever. Of those who do, about half will have a third seizure. Few children have more than three febrile seizures.

If there is a family history, if the first seizure happened before 12 months of age, or if the seizure happened with a fever below 102, a child is more likely to fall in the group that has more than one febrile seizure

DIAGNOSIS OF FEBRILE SEIZURE/ FEVER CONVULSION OR FEBRILE NEUTROPENIA

A good doctor will do a careful study of a febrile seizure. For the first febrile seizure, this will usually include a spinal tap (lumbar puncture) and fluid analysis to make certain that the seizure was not caused by meningitis. Following the termination of the fever, the doctor will stress the importance of fever control for the next few days and will often place the child on anticonvulsant medications.

PREVENTION

To prevent future febrile seizures, give acetaminophen or ibuprofen at the first sign of a fever. (You may want to keep acetaminophen suppositories on hand). Then sponge your child with lukewarm water. Give him cool liquids to drink -- both to lower the temperature and keep him well hydrated.

Because febrile seizures can occur as the first sign of illness, prevention is often not possible. Neither an initial nor recurrent febrile seizure suggests that your child is not being properly cared for.

Occasionally, a physician will prescribe diazepam to prevent or treat recurrent febrile seizures.

Home Treatment

During a convulsion:

Try to stay calm, because that will help calm the child.

Protect the child from injury. Ease the child to the floor, or hold a very small child face down on your lap. Do not restrain the child.

Turn the child onto his or her side. This will help clear the mouth of any vomit or saliva and will keep the airway open so the child can breathe.

Do not put anything in the child's mouth to prevent tongue biting, because it may injure the child.

Time the length of the convulsion, if possible.

After a convulsion:

If the child is having difficulty breathing, turn his or her head _ the side and, using your finger; gently clear the mouth of any vomit or saliva so the child can breathe.

Check for injuries.

Reduce the fever with lukewarm sponge baths

Put the child :In a cool room to sleep. Drowsiness is common following a convulsion. Check the child often. The child should return to his or her normal behavior and activity level within

60 minutes of the convulsion.

When to Call a Health Professional

If the child stops breathing for longer than 30 to 60 seconds. Begin rescue breathing

If the child is younger than 6 months of age, is 6 years older, or if the convulsion only affects one side of the body.

If fever occurs with vomiting, vomiting headache, sleepiness, leth­argy, stiff neck, or a bulging soft spot on an infant's head.

If convulsion occurs without fever.

If it is the child's first convulsion.

If you are unable to reduce fever below 38.3 degree Celsius after a convulsion.