Febrile convulsion or step disease is a seizure in children which triggered by fever, not a disorder in the brain. Febrile seizures usually occur in children aged 6 month to 5 year.
When experiencing a febrile seizure, the child's body will shake violently accompanied by jerking movements in the arms and legs, and lose consciousness. A febrile seizure can look scary, especially to the elderly. In fact, seizures in children that occur when a fever is generally not dangerous and is not a symptom of a serious illness.
Febrile seizures are different from epilepsy or seizures. Epilepsy is characterized by recurrent seizures without necessarily accompanying fever. Although they are generally harmless and only last a short time, call your doctor right away if your child has a febrile seizure for the first time. Parents also need to be alert if a febrile seizure lasts more than 5 minutes and is accompanied by vomiting, stiff neck, and shortness of breath.
Symptoms of a Fever Seizure
Febrile seizures are characterized by the occurrence of seizures during fever. Symptoms of febrile seizures are repetitive jerking of the legs and arms (sag), the eyes squint upwards, and the child loses consciousness.
A febrile seizure usually lasts less than 2 minutes. However, in some cases, febrile seizures can last up to 15 minutes. A child who has a febrile seizure will wake up immediately after the seizure subsides, even if he looks confused or tired. Usually seizures also do not recur within 24 hours. A febrile seizure like this is called a simple febrile seizure.
If the seizure lasts longer than 15 minutes, or occurs more than once in a 24-hour period, the febrile seizure is classified as a complex febrile seizure. Seizures that appear in complex febrile seizures can also occur in only one part of the body. Children who have had febrile seizures are at risk for experiencing them again when they have a fever, especially if the child is under 15 months of age.
When to go to the doctor
A febrile seizure may look scary, but it's actually not dangerous. However, you still need to take your child to the doctor the first time they have a febrile seizure.
Although generally harmless, visit the ED immediately if a febrile seizure in a child lasts longer than 5 minutes. In addition, immediately visit the ER if your child has a febrile seizure accompanied by:
- Throw up
- Looks so sleepy
- Stiff neck
- Hard to breathe
Causes of Fever Seizures
The cause of febrile seizures is not known with certainty. However, fever that causes seizures in children can be triggered by several things, namely:
- Afterimmunization
In some children, immunization can cause a fever that can trigger a febrile seizure.
- InfectionChildren can have seizures when they have a fever due to a viral or bacterial infection.
Children aged 12-18 months have a higher risk of having a febrile seizure than older children. In addition, children born to families with a history of febrile seizures are also more at risk of having febrile seizures.
Fever Seizure Diagnosis
If the child is still in a state of seizures, the doctor will conduct a quick examination and treatment first. After the seizures stop, the doctor will ask the parents several questions, including:
- How long the child has had a seizure.
- Characteristics of seizures experienced, such as jerks all over the body, only stiff, or jerks only in some parts of the body.
- Have you ever had a seizure before or not?
After asking the characteristics of seizures in children, the doctor will also ask about the child's health and family history. Some questions doctors can ask parents are:
- Has the child recently been vaccinated or not.
- Does the child have symptoms of infection?
- Is there a family member with a history of febrile seizures or step.
Then the doctor will conduct an examination to make sure there are no specific causes of seizures or complications that arise. If it is suspected that there are other causes that cause seizures, after a physical examination, the doctor will ask the child's condition to his parents.
Pediatricians can also perform investigations, such as blood, urine, lumbar puncture, brain scan, or electroencephalography (EEG). This examination is carried out if the doctor suspects that another condition is causing the child to have seizures.
Fever Seizure Treatment
In most cases, febrile seizures will go away on their own after a few minutes. However, to protect children from injury during seizures, parents can do the following at home:
- Lay the child on the floor. In infants, lie on the lap with the baby's face facing down. Do not restrain the child's body.
- Tilt the child's body position so that vomit or saliva can come out of the oral cavity, and prevent the tongue from clogging the respiratory tract.
- Loosen the child's clothes and do not put anything in the child's mouth to prevent biting the tongue.
- Count the duration of the febrile seizure and note the child's behavior during the seizure. Tell this when you consult a doctor.
If your child has a simple febrile seizure, you may not want to take your child to the doctor after the seizures have stopped. Even so, it would be better if you still check with the doctor to find out the cause of the fever experienced by the child.
If there is no specific cause of febrile seizures, the doctor may not give any treatment. Your doctor may also prescribe fever-reducing medications, such as paracetamol, or anti-seizure medications, such as diazepam. Generally, the child does not need to be hospitalized, but this depends on the illness causing the fever.
Febrile seizures or step disease are harmless conditions, and can occur in children who have fever without causing complications. After experiencing a febrile seizure, children are generally able to return to their normal activities.
Complications of Fever Seizure
Simple febrile seizures do not cause brain damage or mental disability. One of the complications of febrile seizures is the possibility of having febrile seizures again in the future. The risk will be greater if:
- The time lag between the onset of fever and the appearance of a seizure is quite short.
- The first febrile seizure occurs when the body temperature is not too high.
- The child was under 18 months of age when he had his first febrile seizure.
- Have other family members who have also had febrile seizures.
Children who have febrile seizures have a risk of developing epilepsy later in life, but this risk is present in children who have complex febrile seizures. In addition to epilepsy, children with febrile seizures are at risk of developing brain disorders or encephalopathy. However, this case is very rare.
Fever Seizure Prevention
Febrile seizures generally cannot be prevented, including by administering fever-reducing drugs or anti-seizure drugs. However, if the child has a fever, the doctor can still give fever-reducing medication. Administration of anti-seizure drugs through the rectum is usually only given if the seizure lasts longer than 5 minutes.