Management and Treatment of Paediatric Febrile Seizures 

Febrile seizures are usually associated with mild and extreme fevers in children. Febrile seizures occur with a fever in the absence of intracranial infection. Children suffer from febrile seizures generally as a form of convulsion in the absence of hypoglycaemia or an acute electrolyte imbalance. Most children of the age between six months and six years of age are prone to febrile convulsions or seizures.

Febrile Seizures may be scary for parents with younger kids and become an extreme challenge when handling kids with frequently occurring seizures. Febrile Seizures can be frightening for parents even when generally they might be harmless for children. The current review showcases the right treatment and management of febrile seizures in children with the help of an expert paediatric neurologist, Dr Rakesh Jain. 

Dr Rakesh Jain gives answers to all our general queries related to the management and treatment of febrile seizures in the paediatric age. In fact, he suggests that most children suffering from Febrile Seizures have an excellent diagnosis, and only a few of them develop long-term health problems. 

What are Febrile Seizures? 
Febrile seizures are convulsions that generally occur in children. Febrile Seizures in children are triggered mainly by fever ranging between 100 to 106 degrees Fahrenheit. Febrile Seizures and convulsions are the types of convulsions that are specially characterised between children. According to studies conducted between kids worldwide, more than 3-4% of white children suffer from Febrile Seizures, 6-9% of children in Japan are affected by Febrile Seizures and almost 5-10% of kids in India suffer from paediatric febrile convulsions. 

Febrile Seizures and convulsions can be extremely tiring and frightening for parents with small kids. Even if the seizures occurring because of fever are completely harmless for kids, parents must address the problem most sensitively. 

The evident causes of Febrile Seizures are unknown and require plenty of study. However, when studied by several neurologists and paediatric neurologists, Febrile Seizures indicate a probable association between Febrile Seizures and environmental or genetic factors. Fever in kids sometimes comes as a normal response to an infection or the release of high levels of cytokines during a fever. Kids generally possess higher levels of cytokines during fever after birth and that normally alters the general brain activities. Which further leads to seizures and triggers convulsions. 

Diagnosis of Paediatric Febrile Seizures 
The general diagnosis of a child with febrile seizures begins with a general physician who tries to identify the borderline causes. When a child with febrile seizures is presented to an emergency department, the department officials and medical practitioners must collect accurate and detailed information about the child. The emergency department collects a specific history with a complete evaluation including an all-inclusive neurologic examination. This is carried out to rule out all the possible causes of the convulsions. The emergency department also conducts a differential diagnosis that includes noting if the child shows symptoms of any of the following: 

  • Rigours
  • Febrile delirium or syncope
  • Breath-holding attacks
  • Reflex anoxic seizures
  • Evolving syndromes and symptoms of epilepsy
  • Infections of the central nervous system 
  • Meningitis and brain abscesses

Generally, the paediatric neurologist will collect the history of their family from the parents of the kids with the history of nature, duration, presence of any kind of infectious diseases or fevers. The paediatric neurologist also conducts a complete clinical evaluation that focuses on recognising any kind of infections causing the fever.

Red Flag Symptoms in Paediatric Febrile Seizures 

  • The child is presented to the Emergency Department with complex seizures
  •  Signs and symptoms that involve the meninges (thin layers of tissues that protect the brain and spinal cord)
  • Positive neck stiffness 
  • Higher levels of mindfulness for a long duration after the Febrile Seizure is over 
  • Recurring rashes in an unwell child
  • Persisting Tachycardia 
  • High body temperatures that fail to come down 
  • Positive signs of severe respiratory suffering
  • Tachypnoea and grunting with lack of breath
  • Low oxygen saturation (<92% on air)
  • Recessing chest walls with the inability to breathe properly 

Common Treatment Plans that Paediatric Neurologists Follow
After following a proper procedure for diagnosis and a detailed clinical study, Paediatric Neurologists suggest treatments based on the condition of the child. If the child suffered a simple FS, the child doesn’t require hospitalization and is considered in a good clinical condition. Some kids may also be kept in observation for 5-6 hours. Most FS are short-lived and terminate on their own. However, if a child suffers from recurring febrile seizures, they may require long-term treatment with the help of antiepileptic drugs. The Paediatric Neurologists will check the child for all red flags before prescribing any drugs and antiepileptic drugs.

Febrile seizures are one of the most common and frequently occurring seizures in children. The diagnosis and treatment of all kinds of febrile seizures are necessary as it is crucial to exclude the presence of intracranial infection. 

An expert Paediatric Neurologist will help diagnose and manage Febrile Seizures in kids first by controlling the symptoms and then treating the cause of the high fever.