What are febrile seizures and how do they affect children. How can parents recognize the symptoms of a febrile seizure. What causes febrile seizures and who is at higher risk. How are febrile seizures treated and can they be prevented. When should parents seek immediate medical attention for a child experiencing a seizure.

Understanding Febrile Seizures: A Common Childhood Concern

Febrile seizures are convulsions that occur in young children, typically triggered by a rapid increase in body temperature. These seizures can be alarming for parents, but it’s important to understand that they are generally harmless and don’t indicate a serious underlying condition.

Febrile seizures most commonly affect children between 6 months and 5 years of age, with the highest risk occurring between 12 and 18 months. While frightening to witness, these episodes are usually brief and don’t cause long-term health problems.

Types of Febrile Seizures

Febrile seizures are classified into two main categories:

• Simple febrile seizures: These are the most common type, lasting from a few seconds to 15 minutes. They don’t recur within a 24-hour period and affect the entire body.
• Complex febrile seizures: These last longer than 15 minutes, occur more than once within 24 hours, or are confined to one side of the child’s body.

Recognizing the Symptoms of Febrile Seizures

Identifying a febrile seizure quickly is crucial for proper management. The primary symptoms include:

• A fever higher than 100.4°F (38.0°C)
• Loss of consciousness
• Shaking or jerking of the arms and legs
• Stiffening of the body
• Twitching in one area of the body (in some cases)

Do febrile seizures always occur at the peak of a fever? Not necessarily. Febrile seizures often occur within the first 24 hours of a fever’s onset and can sometimes be the first sign that a child is ill.

Causes and Risk Factors of Febrile Seizures

The primary cause of febrile seizures is a rapid increase in body temperature. This temperature spike is typically due to an underlying infection, most commonly viral, though bacterial infections can also be responsible.

Common Infections Associated with Febrile Seizures

Some infections are more frequently linked to febrile seizures than others:

• Influenza (flu)
• Roseola
• Other viral infections causing high fevers

Can vaccinations trigger febrile seizures? In rare cases, yes. Some childhood vaccinations, such as the diphtheria, tetanus, and pertussis vaccine or the measles-mumps-rubella vaccine, may increase the risk of febrile seizures. However, it’s important to note that it’s the fever following vaccination, not the vaccine itself, that causes the seizure.

Risk Factors for Febrile Seizures

Several factors can increase a child’s likelihood of experiencing a febrile seizure:

1. Age (6 months to 5 years, with peak risk between 12-18 months)
2. Family history of febrile seizures
3. Certain genetic factors
4. Recent vaccinations

Diagnosing and Treating Febrile Seizures

How are febrile seizures diagnosed? Diagnosis typically involves a thorough medical history and physical examination. In some cases, additional tests may be necessary to rule out other potential causes of seizures.

Treatment Approaches

The treatment of febrile seizures focuses on managing the underlying fever and ensuring the child’s safety during the episode. This may include:

• Administering fever-reducing medications (e.g., acetaminophen or ibuprofen)
• Ensuring proper hydration
• Monitoring the child closely
• In some cases, anti-seizure medications may be prescribed for children with recurrent or prolonged seizures

Is long-term medication necessary for children who experience febrile seizures? In most cases, no. The majority of children outgrow febrile seizures and do not require ongoing treatment.

Preventing Febrile Seizures: Strategies for Parents

While it’s not always possible to prevent febrile seizures, there are steps parents can take to reduce their child’s risk:

1. Monitor and manage fevers promptly
2. Ensure proper hydration during illnesses
3. Follow vaccination schedules as recommended by healthcare providers
4. Be aware of family history and discuss any concerns with your pediatrician

Can fever-reducing medications prevent febrile seizures? While these medications can help manage fever symptoms, studies have shown that they don’t significantly reduce the risk of febrile seizures.

When to Seek Immediate Medical Attention

While most febrile seizures are harmless, there are situations where immediate medical care is necessary. Parents should call for emergency medical assistance if:

• The seizure lasts longer than 5 minutes
• The child has difficulty breathing
• The seizure is accompanied by vomiting or a stiff neck
• The child appears extremely sleepy or unresponsive after the seizure
• It’s the child’s first seizure

Should parents try to stop a febrile seizure? No, attempting to physically restrain a child during a seizure can be dangerous. Instead, focus on ensuring the child’s safety by removing nearby objects and gently placing them on their side.

Long-Term Outlook for Children with Febrile Seizures

The prognosis for children who experience febrile seizures is generally excellent. Most children outgrow these seizures by the age of 5 and do not experience any long-term effects on their health or development.

Potential Complications

While rare, some potential complications associated with febrile seizures include:

• Increased risk of epilepsy (though still relatively low)
• Recurrence of febrile seizures
• Psychological impact on parents and caregivers

Do febrile seizures affect a child’s cognitive development? Research has shown that children who experience febrile seizures typically have normal cognitive development and academic performance.

Supporting Children and Families Affected by Febrile Seizures

Experiencing a febrile seizure can be traumatic for both children and their parents. Providing support and education is crucial for managing the emotional impact of these events.

Educational Resources

Parents and caregivers can benefit from various educational resources:

• Informational brochures from pediatricians
• Online support groups for parents of children with febrile seizures
• Educational workshops offered by hospitals or community health centers
• Consultation with pediatric neurologists for complex cases

How can parents prepare for potential future seizures? Creating a seizure action plan with your healthcare provider can help parents feel more confident in managing future episodes. This plan should include steps to take during a seizure, when to seek emergency care, and any specific instructions for your child.

Emotional Support

The emotional impact of febrile seizures shouldn’t be underestimated. Parents may benefit from:

1. Counseling services to address anxiety or stress
2. Connecting with other parents who have gone through similar experiences
3. Open communication with healthcare providers to address concerns
4. Learning relaxation techniques to manage stress during future illnesses

Can febrile seizures be a source of childhood trauma? While witnessing a seizure can be frightening, most children do not remember the event. However, parents should be attentive to any signs of anxiety or behavioral changes in their child following a seizure and seek professional help if needed.

Advances in Febrile Seizure Research and Management

Ongoing research continues to enhance our understanding of febrile seizures and improve management strategies. Some areas of current focus include:

• Genetic studies to identify potential markers for increased seizure risk
• Development of more targeted fever management techniques
• Investigation of potential neuroprotective strategies
• Refinement of guidelines for emergency management of prolonged febrile seizures

What new treatments are on the horizon for febrile seizures? While current management primarily focuses on symptom control and safety, researchers are exploring novel approaches such as intranasal midazolam for rapid seizure cessation and potential preventive medications for high-risk children.

The Role of Telemedicine in Febrile Seizure Management

The growing field of telemedicine offers new opportunities for managing febrile seizures:

1. Remote consultations with pediatric specialists
2. Virtual follow-up appointments to monitor recovery
3. Online educational sessions for parents and caregivers
4. Digital platforms for tracking fever patterns and seizure occurrences

How effective is telemedicine in managing febrile seizures? While in-person evaluation is crucial for initial diagnosis and emergency situations, telemedicine can play a valuable role in follow-up care, education, and ongoing management, especially for families in remote areas.

Febrile Seizures in Different Cultural Contexts

The perception and management of febrile seizures can vary across different cultures. Understanding these differences is crucial for healthcare providers in delivering culturally sensitive care.

Cultural Variations in Febrile Seizure Management

Different cultures may approach febrile seizures in unique ways:

• Traditional medicine practices in some cultures may be used alongside conventional treatments
• Varying levels of stigma associated with seizures in different societies
• Cultural beliefs about the causes of fevers and seizures influencing treatment-seeking behavior
• Differing family dynamics and decision-making processes regarding child health

How can healthcare providers bridge cultural gaps in febrile seizure management? Adopting a culturally competent approach, which includes understanding local beliefs, using interpreters when necessary, and involving family members in care decisions, can greatly improve outcomes and patient satisfaction.

Global Perspectives on Febrile Seizure Research

Febrile seizure research is a global endeavor, with studies conducted across various populations providing valuable insights:

1. Epidemiological studies revealing varying incidence rates across different countries
2. Genetic research identifying population-specific risk factors
3. Comparative studies on treatment approaches in different healthcare systems
4. International collaborations advancing our understanding of febrile seizures

Are there significant differences in febrile seizure prevalence or characteristics across different populations? While the fundamental nature of febrile seizures is consistent globally, factors such as genetic predisposition, environmental influences, and healthcare access can lead to variations in prevalence and outcomes across different populations.

In conclusion, febrile seizures, while frightening, are generally benign events that most children outgrow. Understanding the causes, symptoms, and appropriate management strategies can help parents and caregivers navigate these episodes with confidence. As research continues to advance our knowledge, the outlook for children experiencing febrile seizures continues to improve, with a focus on personalized care and long-term well-being.

Febrile seizure – Symptoms and causes

Overview

A febrile seizure is a convulsion in a child that’s caused by a fever. The fever is often from an infection. Febrile seizures occur in young, healthy children who have normal development and haven’t had any neurological symptoms before.

It can be frightening when your child has a febrile seizure. Fortunately, febrile seizures are usually harmless, only last a few minutes, and typically don’t indicate a serious health problem.

You can help by keeping your child safe during a febrile seizure and by offering comfort afterward. Call your doctor to have your child evaluated as soon as possible after a febrile seizure.

Symptoms

Usually, a child having a febrile seizure shakes all over and loses consciousness. Sometimes, the child may get very stiff or twitch in just one area of the body.

A child having a febrile seizure may:

• Have a fever higher than 100.4 F (38.0 C)
• Lose consciousness
• Shake or jerk the arms and legs

Febrile seizures are classified as simple or complex:

• Simple febrile seizures. This most common type lasts from a few seconds to 15 minutes. Simple febrile seizures do not recur within a 24-hour period and are not specific to one part of the body.
• Complex febrile seizures. This type lasts longer than 15 minutes, occurs more than once within 24 hours or is confined to one side of your child’s body.

Febrile seizures most often occur within 24 hours of the onset of a fever and can be the first sign that a child is ill.

When to see a doctor

See your child’s doctor as soon as possible after your child’s first febrile seizure, even if it lasts only a few seconds. Call an ambulance to take your child to the emergency room if the seizure lasts longer than five minutes or is accompanied by:

• Vomiting
• A stiff neck
• Breathing problems
• Extreme sleepiness

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Causes

Usually, a higher than normal body temperature causes febrile seizures. Even a low-grade fever can trigger a febrile seizure.

Infection

The fevers that trigger febrile seizures are usually caused by a viral infection, and less commonly by a bacterial infection. The flu (influenza) virus and the virus that causes roseola, which often are accompanied by high fevers, appear to be most frequently associated with febrile seizures.

Post-vaccination seizures

The risk of febrile seizures may increase after some childhood vaccinations. These include the diphtheria, tetanus and pertussis vaccine and the measles-mumps-rubella vaccine. A child can develop a low-grade fever after a vaccination. The fever, not the vaccine, causes the seizure.

Risk factors

Factors that increase the risk of having a febrile seizure include:

• Young age. Most febrile seizures occur in children between 6 months and 5 years of age, with the greatest risk between 12 and 18 months of age.
• Family history. Some children inherit a family’s tendency to have seizures with a fever. Additionally, researchers have linked several genes to a susceptibility to febrile seizures.

Complications

Most febrile seizures produce no lasting effects. Simple febrile seizures don’t cause brain damage, intellectual disability or learning disabilities, and they don’t mean your child has a more serious underlying disorder.

Febrile seizures are provoked seizures and don’t indicate epilepsy. Epilepsy is a condition characterized by recurrent unprovoked seizures caused by abnormal electrical signals in the brain.

Recurrent febrile seizures

The most common complication is the possibility of more febrile seizures. The risk of recurrence is higher if:

• Your child’s first seizure resulted from a low-grade fever.
• The febrile seizure was the first sign of illness.
• An immediate family member has a history of febrile seizures.
• Your child was younger than 18 months at the time of the first febrile seizure.

Prevention

Most febrile seizures occur in the first few hours of a fever, during the initial rise in body temperature.

Giving your child medications

Giving your child infants’ or children’s acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) at the beginning of a fever may make your child more comfortable, but it won’t prevent a seizure.

Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children.

Prescription prevention medications

Rarely, prescription anticonvulsant medications are used to try to prevent febrile seizures. However, these medications can have serious side effects that may outweigh any possible benefit.

Rectal diazepam (Diastat) or nasal midazolam might be prescribed to be used as needed for children who are prone to long febrile seizures. These medications are typically used to treat seizures that last longer than five minutes or if the child has more than one seizure within 24 hours. They are not typically used to prevent febrile seizures.

Feb. 24, 2021

8 Things to Do + When to Call 9-1-1 – Health Essentials from Cleveland Clinic

As parents, we know about kids with colds, runny noses and ear infections. We’ve knelt with our stomach-sick children on the bathroom floor, and we’ve felt their foreheads and wiped their tears. But if a fever were to cause a seizure, few of us are equipped to respond.

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One in every 20 children with fever experiences a fever-related, or febrile, seizure. These children are typically between the ages of 6 months and 5 years.

A child may convulse or stiffen and lose consciousness for several minutes, then awaken and rapidly recover.

“It is traumatic to watch,” says neurologist Ajay Gupta, MD, Section Head of Pediatric Epilepsy in Cleveland Clinic’s Epilepsy Center.  But most of the time, febrile seizures don’t happen more than once — whether during the same illness or as a result of future fevers.

Fewer than 5 percent of children who experience febrile seizures will go on to experience epileptic seizures, which do recur.

How seizures and epilepsy relate

The term “epilepsy” doesn’t refer to a specific disease, but to a tendency to have recurrent, unprovoked seizures over time. Possible causes of seizures in children and adolescents are:

“Most febrile or fever-related seizures are harmless,” Dr. Gupta says.

The 5 percent of children experiencing febrile seizures who develop epilepsy typically have one or more of the following indicators:

• Family history of epilepsy.
• Neurological disability (such as cerebral palsy).
• Developmental delays.
• Partial (one limb or one side) or prolonged (more than 15 minutes) or multiple febrile seizures during the same illness.

Children without these risk factors most likely will not develop epilepsy, Dr. Gupta says.

What to do if your child has a seizure

“It’s very important that you don’t panic if your child has a seizure,” says Dr. Gupta. “Instead, try to stay calm and observe the child.”

To keep your child safe and prevent accidental injury during a seizure, he advises parents to do the following:

1. Place the child on a soft surface, such as a bed.
2. Prevent choking by laying the child on his or her side or stomach.
3. Ensure that the child is breathing adequately.
4. Never place anything in the child’s mouth during a convulsion.
5. Gently clean saliva or other debris from the child’s mouth with a soft cloth.
6. Check the time when the seizure begins and note how long it lasts.
7. Administer any treatment that your doctor has prescribed to stop seizure if this is a recurrence of febrile seizure. Call 9-1-1 if the seizure does not stop within three to five minutes or the child does not fully regain consciousness.
8. When fully awake, give your child a medication (like acetaminophen, ibuprofen) to reduce fever.

Dr. Gupta says most fever-induced seizures last for less than three minutes. He advises that you take your child to the pediatrician so your doctor can find the fever’s source.

Your description of your child’s seizure is important for helping the pediatrician with the evaluation. The doctor will likely perform a physical examination and possibly some basic tests to ensure that nothing other than a fever has triggered the seizure.

“The child should be assessed to rule out an infection such as meningitis, as well as metabolic problems such as dehydration, low levels of glucose or sodium. Any of these underlying causes for seizure must be treated promptly,” Dr. Gupta says. “The only additional things the child needs are acetaminophen to lower the fever; hydration with water, soup or popsicles; and TLC.”

Dr. Gupta says parents should educate themselves about febrile seizures. Also, ask your pediatrician for tips on keeping your child’s fever down during an illness. This may decrease the chances of fever-related seizures.

Take faster action if you see these signs

If convulsions last five minutes or longer, take the child to the nearest medical facility for evaluation right away.

“Also, seek urgent medical attention for a child who shows symptoms of extreme lethargy, vomiting or a stiff neck,” says Dr. Gupta.

Other causes for concern include:

• A seizure that occurs on only one side of the body.
• A fever of 104 degrees or higher.
• More than one seizure in one day during the same illness.
• A seizure with no associated fever or illness.

If any symptoms cause you concern, contact your pediatrician.

Call 9-1-1 in two situations

The following situations are emergencies, Dr. Gupta stresses. Parents should call 9-1-1 promptly if:

1. A child has a convulsive seizure that lasts longer than five minutes.
2. A child has repeated seizures and does not fully return to normal in between them.

When to test for a neurological illness

Children with febrile seizures should be evaluated for neurological issues if they have:

• More than one seizure in 24 hours.
• More than one seizure during a single illness.
• Seizures affecting only one part or side of the body.
• Developmental delays or an abnormal neurological exam.

Neurological illness can cause repeated or longer-lasting febrile seizures and even seizures without fever, says Dr. Gupta. In both cases, additional testing is needed. And when doctors suspect that prolonged febrile seizures (longer than five minutes) are likely to recur, they can prescribe medication for parents to administer at home.

“Rapidly stopping the seizure may avoid an emergency room visit or hospital admission,” Dr. Gupta says.

Key takeaways for parents

Seizures have many causes and are fairly common in children, so don’t panic if your child has one.

It doesn’t necessarily mean he or she has epilepsy, nor does it mean the child has a greater risk of developing epilepsy in the future, says Dr. Gupta.

A seizure occurs when many brain cells abnormally fire at the same time. This temporarily disrupts the brain’s normal electrical signals. The intense, excessive electrical activity overwhelms the brain and may cause changes in behavior, awareness and body movements.

Overview, Symptoms, Treatment and Prevention

Babies and children often have illnesses with fever. For most children fever causes only minor discomfort that can be relieved with acetaminophen (Children’s Tylenol®) or ibuprofen (Children’s Motrin® or Advil®). But in a few children, fever can bring on a seizure or a convulsion. These are called febrile (FEB rill) seizures. Sometimes a seizure is the first sign that a child has a fever.

Febrile seizures are common. A few children will have one at some time – usually between the ages of 6 months and 5 years. Most children outgrow them by age 6. Almost a third of children who have had one seizure will have others. While scary to parents, febrile seizures usually do not last long and do not cause brain damage, learning disabilities or epilepsy.

Facts About Febrile Seizures

• Febrile seizures usually happen on the first day and in the first hours of fever.
• Febrile seizures can be caused by:
  • A temperature of 100.4˚ F or higher
  • A viral or bacterial infection such as flu, chickenpox, or an ear infection
  • A recent vaccine that causes a fever. The fever, not the vaccine, triggers the seizure.
• A child is at risk to have more than one seizure if:
  • There is a family history of febrile seizures.
  • The first seizure occurs before age one.
• There are two types of febrile seizures.
  • Simple (typical): This type is more common. The child has one seizure in 24 hours. It affects the entire body and lasts less than 15 minutes.
  • Complex (atypical): This type affects either one part or one side of the body. A child may have more than one seizure in 24 hours. Each may last more than 15 minutes.

Signs of a Febrile Seizure

During a febrile seizure, a child may:

• Flutter eyelids or roll the eyes
• Stiffen, jerk or twitch the muscles of the arms and legs
• Clench the teeth or jaw
• Lose bladder or bowel control
• Lose consciousness
• Have irregular breathing

What You Can Do

There is nothing you can do to make the seizure stop. The most important thing is for you to stay calm and protect your child from injury.

• If your child is sitting or standing, gently ease him or her to the floor. Remove things
  nearby that can hurt him.
• Place your child on a soft surface, lying on his side
  and turn the head to face downward (Picture 1).
• Loosen tight clothing. If your child wears glasses,
  remove them.
• Look to see exactly how your child moves and
  responds to you so you can describe it later.
• Time how long the seizure lasts. If the seizure
  stops in less than 5 minutes, contact your child’s
  doctor for further instructions.

What Not to Do

• Do not try to open your child’s mouth or place anything between the teeth. This could
  injure the gums or break teeth.
• Do not try to stop or restrain your child’s movements.
• Do not put your fingers into his mouth. He might accidentally bite them.
• Do not use cold water or add alcohol to bath water to bring a fever down.

When to Call for Help

Have someone call 911 for emergency help if any of these things happens:

• The seizure lasts more than 5 minutes. The emergency squad can give medicine to stop
  the seizure.
• Your child has trouble breathing during the seizure and his skin or lips change in color.
• Your child chokes on secretions (blood, vomit, etc.)
• Your child is injured during a fall or during the seizure and requires first aid (cut, broken bone).

Call your child’s doctor if he:

• Has a febrile seizure for the first time
• Has more than one febrile seizure
• Looks very ill, is very fussy or is hard to wake up
• Has a stiff neck, bad headache, very sore throat, painful stomachache, unusual rash or keeps vomiting and has diarrhea
• Is younger than 2 months of age and has a rectal temperature of 100.4˚ F or higher
• Fever comes back and lasts for 3 days or longer
• Shows signs of dehydration – dry or sticky mouth, sunken eyes, or not urinating

After the Seizure

When the movements stop, your child may be quite groggy and confused. He may complain of a mild headache or be a little cranky or tired for a day or so. He will probably not remember having a seizure. There is no need to change your lifestyle or the way you care for your child.

• Your child can safely sleep in his own bed or crib. Be sure to remove extra pillows and
  soft toys from the bed. For a preschooler, you may want to think about using guardrails on the bed.
• If your child is acting sick and has other signs of illness, follow your doctor’s advice as you normally would.

Prevention and Treating a Fever

Talk with your child’s doctor about ways to treat a fever. Treating the fever with medicines may help your child feel more comfortable but it will not prevent a seizure.

Medicines such as ibuprofen or acetaminophen can be used for a fever higher than 101˚F or if your child is uncomfortable. Make sure that you are using the right strength for the age of your child. (Picture 2).

• Follow the directions on the package of all medicines.
  • Acetaminophen (Tylenol®) may be used in children over 2 months.
  • Ibuprofen (Advil®, Motrin®) may be used in children over 6 months.
  • Do NOT give aspirin to children. Aspirin has been linked to a disease called Reye’s syndrome, which can be fatal.

• Give sponge baths after giving medicine. Use water that is lukewarm (85˚F to 90˚F). Sponge the water over the child’s body if he cannot be placed in the bathtub (Picture 3).
• Recheck your child’s temperature 15 minutes after the sponge bath. If the temperature is over 103˚F or is going higher, repeat the sponging.
• Undress your child when indoors. Do not cover him with blankets.
• If your child is having febrile seizures very often, his doctor may prescribe a medicine to use.

Fever and Seizures (Febrile Seizures) (PDF)

HH-I-195 5/98  Revised 3/18  Copyright 1998, Nationwide Children’s Hospital

Fever Seizures | Michigan Medicine

Has your child had a fever seizure?

Fever seizures are uncontrolled muscle spasms that can happen when a child’s body temperature goes up quickly.

How old are you?

Less than 6 months

Less than 6 months

6 months to 2 years

6 months to 2 years

7 years or older

7 years or older

Are you male or female?

Why do we ask this question?

• If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
• If your symptoms aren’t related to those organs, you can choose the gender you identify with.
• If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Is this your child’s first seizure?

Have the child’s other seizures occurred during the same illness (within the past day or so)?

Yes

Seizures occurred during same illness

No

Seizures occurred during same illness

Has the seizure lasted more than 3 minutes?

Yes

Seizure lasting more than 3 minutes

No

Seizure lasting more than 3 minutes

Is your child having trouble drinking enough to replace the fluids he or she has lost?

Little sips of fluid usually are not enough. The child needs to be able to take in and keep down plenty of fluids.

Yes

Unable to drink enough fluids

No

Able to drink enough fluids

Would you describe the breathing problem as severe, moderate, or mild?

Severe

Severe difficulty breathing

Moderate

Moderate difficulty breathing

Mild

Mild difficulty breathing

Have tiny red or purple spots or bruises appeared suddenly?

Yes

Sudden appearance of red or purple spots or bruising

No

Sudden appearance of red or purple spots or bruising

Does your child have pain?

How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?

8 to 10: Severe pain

Severe pain

5 to 7: Moderate pain

Moderate pain

1 to 4: Mild pain

Mild pain

Do you think your child has a fever?

Did you take your child’s temperature?

How high is the fever? The answer may depend on how you took the temperature.

High: 104°F (40°C) or higher, oral

High fever: 104°F (40°C) or higher, oral

Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral

Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral

Mild: 100.3°F (37.9°C) or lower, oral

Mild fever: 100.3°F (37.9°C) or lower, oral

How high do you think the fever is?

Moderate

Feels fever is moderate

Mild or low

Feels fever is mild

Does your child have a health problem or take medicine that weakens his or her immune system?

Yes

Disease or medicine that causes immune system problems

No

Disease or medicine that causes immune system problems

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

• Your age. Babies and older adults tend to get sicker quicker.
• Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
• Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
• Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
• Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

• Try home treatment to relieve the symptoms.
• Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Sudden tiny red or purple spots or sudden bruising may be early symptoms of a serious illness or bleeding problem. There are two types.

Petechiae (say “puh-TEE-kee-eye”):

• Are tiny, flat red or purple spots in the skin or the lining of the mouth.
• Do not turn white when you press on them.
• Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.
• May spread over a large area of the body within a few hours.
• Are different than tiny, flat red spots or birthmarks that are present all the time.

Purpura (say “PURR-pyuh-ruh” or “PURR-puh-ruh”):

• Is sudden, severe bruising that occurs for no clear reason.
• May be in one area or all over.
• Is different than the bruising that happens after you bump into something.

If you’re not sure if a child’s fever is high, moderate, or mild, think about these issues:

With a high fever:

• The child feels very hot.
• It is likely one of the highest fevers the child has ever had.

With a moderate fever:

• The child feels warm or hot.
• You are sure the child has a fever.

With a mild fever:

• The child may feel a little warm.
• You think the child might have a fever, but you’re not sure.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in children are:

• Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
• Steroid medicines, which are used to treat a variety of conditions.
• Medicines taken after organ transplant.
• Chemotherapy and radiation therapy for cancer.
• Not having a spleen.

Symptoms of difficulty breathing can range from mild to severe. For example:

• You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
• It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example:

• The child may be breathing a little faster than usual (mild difficulty breathing), or the child may be having so much trouble that the nostrils are flaring and the belly is moving in and out with every breath (severe difficulty breathing).
• The child may seem a little out of breath but is still able to eat or talk (mild difficulty breathing), or the child may be breathing so hard that he or she cannot eat or talk (severe difficulty breathing).

Severe trouble breathing means:

• The child cannot eat or talk because he or she is breathing so hard.
• The child’s nostrils are flaring and the belly is moving in and out with every breath.
• The child seems to be tiring out.
• The child seems very sleepy or confused.

Moderate trouble breathing means:

• The child is breathing a lot faster than usual.
• The child has to take breaks from eating or talking to breathe.
• The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

• The child is breathing a little faster than usual.
• The child seems a little out of breath but can still eat or talk.

Symptoms of heatstroke may include:

• Feeling or acting very confused, restless, or anxious.
• Trouble breathing.
• Sweating heavily, or not sweating at all (sweating may have stopped).
• Skin that is red, hot, and dry, even in the armpits.
• Passing out.
• Seizure.
• Nausea and vomiting.

Heatstroke occurs when the body can’t control its own temperature and body temperature continues to rise.

Babies can quickly get dehydrated when they lose fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

• The baby may be fussy or cranky (mild dehydration), or the baby may be very sleepy and hard to wake up (severe dehydration).
• The baby may have a little less urine than usual (mild dehydration), or the baby may not be urinating at all (severe dehydration).

You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

• You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
• You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).

Severe dehydration means:

• The baby may be very sleepy and hard to wake up.
• The baby may have a very dry mouth and very dry eyes (no tears).
• The baby may have no wet diapers in 12 or more hours.

Moderate dehydration means:

• The baby may have no wet diapers in 6 hours.
• The baby may have a dry mouth and dry eyes (fewer tears than usual).

Mild dehydration means:

• The baby may pass a little less urine than usual.

Severe dehydration means:

• The child’s mouth and eyes may be extremely dry.
• The child may pass little or no urine for 12 or more hours.
• The child may not seem alert or able to think clearly.
• The child may be too weak or dizzy to stand.
• The child may pass out.

Moderate dehydration means:

• The child may be a lot more thirsty than usual.
• The child’s mouth and eyes may be drier than usual.
• The child may pass little or no urine for 8 or more hours.
• The child may feel dizzy when he or she stands or sits up.

Mild dehydration means:

• The child may be more thirsty than usual.
• The child may pass less urine than usual.

Symptoms of serious illness in a baby may include the following:

• The baby is limp and floppy like a rag doll.
• The baby doesn’t respond at all to being held, touched, or talked to.
• The baby is hard to wake up.

Symptoms of serious illness may include:

• A severe headache.
• A stiff neck.
• Mental changes, such as feeling confused or much less alert.
• Extreme fatigue (to the point where it’s hard for you to function).
• Shaking chills.

Symptoms of a joint infection may include:

• Severe pain.
• Swelling.
• Sudden redness over or around the joint.
• Warmth in or around a joint.
• Not being able to move the joint because of pain or swelling.
• Pus draining from the area.

Pain in children 3 years and older

• Severe pain (8 to 10): The pain is so bad that the child can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
• Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and sleep, but the child can tolerate it for hours or days.
• Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.

Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.

Oral (by mouth), ear, or rectal temperature

• High: 104° F (40° C) and higher
• Moderate: 100.4° F (38° C) to 103.9° F (39.9° C)
• Mild: 100.3° F (37.9° C) and lower

A forehead (temporal) scanner is usually 0. 5° F (0.3° C) to 1° F (0.6° C) lower than an oral temperature.

Armpit (axillary) temperature

• High: 103° F (39.5° C) and higher
• Moderate: 99.4° F (37.4° C) to 102.9° F (39.4° C)
• Mild: 99.3° F (37.3° C) and lower

Note: For children under 5 years old, rectal temperatures are the most accurate.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

• Passing out (losing consciousness).
• Being very sleepy or hard to wake up.
• Not responding when being touched or talked to.
• Breathing much faster than usual.
• Acting confused. The child may not know where he or she is.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

• Call your doctor now to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don’t have one, seek care in the next hour.
• You do not need to call an ambulance unless:
  • You cannot travel safely either by driving yourself or by having someone else drive you.
  • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

• Call your doctor today to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don’t have one, seek care today.
• If it is evening, watch the symptoms and seek care in the morning.
• If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seizures

Febrile seizures – NHS

Febrile seizures (febrile convulsions) are fits that can happen when a child has a fever. They most often happen between the ages of 6 months and 3 years.

It can be frightening and distressing to see your child having a seizure, particularly if it’s their first seizure.

However, these seizures are usually harmless and almost all children make a complete recovery afterwards.

As a precaution, you may still need to take your child to the nearest hospital or call 999 and ask for an ambulance. See What to do during a seizure.

Signs of a febrile seizure

A febrile seizure usually lasts for less than 5 minutes. Your child will:

• become stiff and their arms and legs may begin to twitch
• lose consciousness and may wet or soil themselves

They may also be sick and foam at the mouth, and their eyes may roll back.

After the seizure, your child may be sleepy for up to an hour. A straightforward febrile seizure like this will only happen once during your child’s illness.

Occasionally, febrile seizures can last longer than 15 minutes and symptoms may only affect one area of your child’s body.

These are known as complex febrile seizures. These seizures sometimes happen again within 24 hours or during the period in which your child is ill.

What to do during a febrile seizure

If your child is having a febrile seizure, place them in the recovery position. Stay with your child and try to make a note of how long the seizure lasts.

Do not put anything into your child’s mouth during a seizure – including medicine – as there’s a slight chance they might bite their tongue.

Take your child to the nearest hospital or call 999 and ask for an ambulance if:

• your child is having a seizure for the first time
• the seizure lasts longer than 5 minutes and shows no signs of stopping
• you suspect the seizure is being caused by another serious illness – for example, meningitis
• your child is having breathing difficulties

While it’s unlikely that there’s anything seriously wrong, it’s important to get your child checked.

If your child has had febrile seizures before and the seizure lasts for less than 5 minutes, call a GP, use NHS 111 or call 111 for advice.

You should also contact a GP or NHS 111 if you think your child is showing signs and symptoms of dehydration (a lack of fluid in the body).

Seeing a doctor

Febrile seizures can often be diagnosed from a description of what happened. It’s unlikely that a doctor will see the seizure happening, so it’s useful to note:

• how long the seizure lasted
• what happened, such as body stiffening, twitching of the face, arms and legs, staring, and loss of consciousness
• whether your child recovered within 1 hour
• whether they’ve had a seizure before

Further tests, such as a blood test or urine test, may be needed if the cause of your child’s illness is not clear.

It can sometimes be difficult to get a urine sample from young children, so it may have to be done in hospital.

Further testing and observation in hospital is also usually recommended if your child’s symptoms are unusual or they’re having complex febrile seizures, particularly if they’re younger than 12 months old.

The tests that may be recommended include:

• an electroencephalogram (EEG), which measures your child’s electrical brain activity by placing electrodes on their scalp. Unusual patterns of brain activity can sometimes indicate epilepsy.
• a lumbar puncture, where a small sample of cerebrospinal fluid (CSF) is removed from the spine for testing. CSF is a clear fluid that surrounds and protects the brain and spinal cord. A lumbar puncture can be used to determine whether your child has an infection of the brain or nervous system.

Causes of febrile seizures

The cause of febrile seizures is unknown, although they’re linked to the start of a high temperature (fever).

There may also be a genetic link to febrile seizures, as the chances of having a seizure are increased if a close family member has a history of them.

In most cases, the child’s high temperature is caused by an infection. Common examples are chickenpox, flu, a middle ear infection or tonsillitis.  

In very rare cases, febrile seizures can happen after a child has a vaccination.

Recurring febrile seizures

About 1 in 3 children who have had a febrile seizure will have another seizure during a subsequent infection. This often happens within a year of the first one.

Recurrence is more likely if:

• the first febrile seizure happened before your child was 18 months old
• there’s a history of seizures or epilepsy in your family
• before having their first seizure, your child had a fever that lasted less than an hour or their temperature was under 40C 
• your child previously had a complex febrile seizure (more than one seizure during their illness)
• your child attends a day care nursery – this increases their chances of developing common childhood infections, such as the flu or chickenpox

It’s not recommended that your child is given a prescription of regular medicines to prevent further febrile seizures.

This is because the adverse side effects associated with many medicines outweigh any risks of the seizures themselves.

Research has shown the use of medicines to control high temperatures is not likely to prevent further febrile seizures.

However, there may be exceptional circumstances where medicine to prevent recurrent febrile seizures is recommended.

For example, children may need medicine if they have a low threshold for having seizures during illness, particularly if the seizures last a long time.

In this case, your child may be prescribed medicine such as diazepam or lorazepam to take at the start of a fever.

Children who’ve had a febrile seizure after a routine vaccination – which is very rare – are no more at risk of having another seizure than children who had a seizure because of illness.

Complications of febrile seizures

Febrile seizures have been linked to an increased risk of epilepsy.

Many parents worry that if their child has one or more febrile seizures, they’ll develop epilepsy when they get older. Epilepsy is a condition where a person has repeated seizures without a fever.

While it’s true that children who have a history of febrile seizures have an increased risk of developing epilepsy, it should be stressed that the risk is still small.

It’s estimated that children with a history of simple febrile seizures have a 1 in 50 chance of developing epilepsy in later life.

Children with a history of complex febrile seizures have a 1 in 20 chance of developing epilepsy in later life.

People who have not had febrile seizures have around a 1 to 2 in 100 chance of developing epilepsy.

Page last reviewed: 26 November 2019
Next review due: 26 November 2022

Febrile Seizures | Epilepsy Foundation

Who gets febrile seizures?

Children aged 3 months to 5 or 6 years may have seizures when they have a high fever. These are called febrile seizures (pronounced FEB-rile) and occur in 2% to 5% of all children (2 to 5 out of 100 children). There is a slight tendency for them to run in families. If a child’s parents, brothers or sisters, or other close relatives have had febrile seizures, the child is a bit more likely to have them.

Sometimes the seizure comes “out of the blue” before it is recognized that the child is ill. A fever may begin silently in a previously healthy child. A seizure can be the first sign that alerts the family that the child is ill.

What types of febrile seizures are there?

Febrile seizures have been divided two groups, simple or complex.

Febrile seizures are considered “simple” if they meet all of the following criteria:

• Generalized full body convulsions
• Last less than 15 minutes
• No more than one in a 24-hour period

Febrile seizures are considered “complex or complicated” if any of the following features are present:

• Start focally with one body part moving independently of others
• Last more than 15 minutes
• Occur more than once in a 24-hour period

What tests need to be done?

The most important question that needs to be answered in a child with a febrile seizure is, “What is the cause of the fever?” Even if the seizure is over, any young child who has a seizure with fever should be seen by a doctor to make sure they do not have a brain infection, such as meningitis.

• Your doctor will ask questions about any symptoms suggestive of infection and perform a careful physical exam to look for signs of infection.
• Blood tests may be needed.
• A spinal tap may be needed in some cases if your doctor is worried about meningitis. This is done more commonly in children under 12 months of age, but rarely is needed in older children.
• Although an EEG (electroencephalogram) and MRI (magnetic resonance imaging) are not needed most of the time, these may be done when a seizure is very prolonged, if the seizure begins focally, or if there are any concerns on examination.

How are febrile seizures treated?

Febrile seizures cannot be prevented by giving the child lukewarm baths, applying cool cloths to the child’s head or body, or using fever-reducing medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Doing these things may make a feverish child feel better, but they do not prevent febrile seizures.

During a seizure:

• Place the child on his or her side on a protected surface and watch carefully.
• Keep track of the time. If the seizure lasts longer than 5 minutes, call 911 or take the child to an emergency room.

Most children who have febrile seizures do not require daily treatment with seizure medicines. However, children who have a history of prolonged febrile seizures and those who live in more remote areas with poor access to prompt medical care should be given a rescue medication.

• A rescue medicine is designed to stop seizures fast. They are meant to be used in certain situations, not daily.
• For a child with febril seizures, the health care provider may ask that they be given a rescue medicine at the time of another febrile seizure lasting longer than 3-5 minutes.
• Examples of rescue medication include diazepam (Diastat) gel given rectally, midazolam liquid given nasally, or diazapam nasally or orally. (Nasal forms of medicines are being reviewed by the U.S. Food and Drug Administration.)

Giving the child diazepam (Valium) when illness or fever begins can reduce the risk of having another febrile seizure.

• However, to prevent one febrile seizure in this way, 14 other children who were never destined to have another febrile seizure will receive the medicine needlessly!
• 3 out of 10 children treated with diazepam have troublesome side effects, such as sleepiness, irritability, and poor coordination, that may last for several days.

If your child has frequent febrile seizures, talk to your health care team about the best approach to prevent or treat seizures.

What’s the outlook?

Among children who have their first febrile seizure before their first birthday, half will have at least one more. Among children who are older than 1 year when the first seizure occurs, about 1 in 4 will have more.

The long-term outlook is excellent, however. The vast majority of children with febrile seizures do not have seizures without fever after age 5.

What are the risks for developing epilepsy later?

• Problems with the child’s development before the febrile seizure
• Having complex or complicated febrile seizures that last longer than 15 minutes, more than one seizure in 24 hours, or seizures in which only one side of the body is affected
• Seizures without fever in a parent or a brother or sister

How do those risks factor into the chance my child will develop epilepsy?

• If the child has none of these risk factors, the chances of epilepsy developing later are only 1% to 2% (1 or 2 out of 100). This is very similar to the risk of developing epilepsy in any other child.
• Children with 1 of these risk factors have a 2.5% (1 in 40) chance of later epilepsy.
• For children with 2 or 3 risk factors, their chance of developing epilepsy later ranges from 5% (1 in 20) to over 10% (greater than 1 in 10).
• In rare cases, febrile seizures that last more than 30 minutes may cause scar tissue in the temporal lobe of the brain. In some of these children, chronic epilepsy develops.

If you have concerns about your child’s febrile seizures, consider consulting a pediatric neurologist or epileptologist.

Febrile (Fever) Seizures: Symptoms, Causes, Treatment

If your child ever had a febrile (fever) seizure, it’s something you probably won’t forget. But while these fits and spasms look scary, usually there are no long-term effects.

Doctors aren’t certain about how it’s triggered. A temperature above 100.4 F may do it, or the seizure may be a result of how quickly your child’s fever spikes. You’re likely to notice the seizure, then feel that she’s burning up. It may be the first indication you have of her being sick.

Who Gets a Febrile Seizure?

Kids between 3 months and 6 years of age can get one. But they’re most common in toddlers between 12 and 18 months. Children usually outgrow them by the time they’re 6 years old.

Your child is more likely to get one if other people in your family have had one. A second seizure also is more likely once your child has had the first one.

What Does It Look Like?

That depends on the type of febrile seizure.

Simple seizures: These are the most common and usually are over in a minute or two. But they can last as long as 15 minutes.

Symptoms include:

• Convulsions – shaking and twitching all over the body
• Fever of 100.4 or greater
• Eye-rolling
• Unresponsiveness
• Moaning
• Losing bowel or bladder control
• Bleeding tongue or mouth from biting down

Your child may feel sleepy, irritable, cranky or confused for a few hours once it’s over.

Complex seizures: These are less common and can last longer than 15 minutes. Your child may have more than one in a day. Only one part of your child’s body may twitch or shake. Afterwards, her arm or leg may feel weak.

A complex febrile seizure is a greater concern. It may require additional examination or hospital admission.

What Causes Them?

Any time your child has a temperature and is under the age of 6, a febrile seizure is possible. These are the most common reasons for a fever:

Continued

Infections: If your child picked up a bacterial or viral infection she may get a temperature. Roseola, also known as sixth disease, is often a culprit because it causes a fever to spike quickly.

Vaccinations: Fevers may follow some immunizations — especially the one for measles, mumps and rubella (MMR). Your child may get a temperature 8 to 14 days after the shot.

How Can I Help My Child?

Stay calm and act fast to prevent an injury:

• Move your child to a safe place (like the floor) so she can’t fall.
• Roll her onto her side so she doesn’t choke on saliva or vomit.
• Don’t put anything in your child’s mouth.
• Don’t hold her down or try to control the convulsions.

Call your doctor after it’s over. Your child may need to be seen to find out what’s causing the fever.

Some children, especially babies under 12 months old, may need medical tests. Your doctor may want to make sure the fever is not caused by meningitis — a serious infection in the brain’s lining.

Should I Get Emergency Help?

Call 911 if:

• The seizure lasts longer than 5 minutes.
• Your child is having trouble breathing or is turning blue.
• Just one part of the body is jerking or twitching.
• Your child is acting odd an hour or more afterwards.
• She looks dehydrated.
• Another seizure happens within 24 hours.

Will It Happen Again?

About 35% of kids who’ve had a febrile seizure will get another within a year or two. Children who are younger than 15 months when they have the first one are more likely to have a repeat.

It won’t necessarily happen every time your child has a fever or at the same temperature as the first.

Can My Child Be Treated?

Your doctor may prescribe antiseizure medicine to give your child at home. That’s more likely after a complex seizure. One dose of diazepam gel put into your child’s bottom usually stops the convulsions.

Do Febrile Seizures Cause Other Problems?

Simple febrile seizures don’t cause brain damage or affect your child’s ability to learn. It’s not the same thing as epilepsy. That’s when a child has two or more seizures without a fever. Having febrile seizures only slightly raises your child’s chances of eventually getting epilepsy.

Your child should have normal development and learning after a febrile seizure. A simple febrile seizure should not cause any long-term consequences.

90,000 Convulsions, shortness of breath, high fever, vomiting in a child – when to call an ambulance

Many parents skillfully cope with the child’s malaise on their own, some go to the pediatrician, but the next day or after the baby’s well-being improves. But there are conditions that require immediate medical attention. And if the team did not arrive within half an hour, then the parents must independently, quickly and urgently get to the medical facility.

If the child has digestive problems

Vomiting in a child may indicate a mass of complex and dangerous diseases, but you should not panic.First, pay attention to the nature of the vomiting – how often it happens, how the child feels, whether there are any impurities of blood, abundant mucus in the vomit. For such an assessment of the child’s condition, 15 minutes will be enough, and only then it will be necessary to make a decision about calling the ambulance team.

A single vomiting without an increase in body temperature and an unchanged condition of the child does not require an appeal to the emergency teams. In all other cases, call the doctors immediately! Vomiting with an admixture of bile (the child will complain that his mouth is bitter) and blood in the child’s stool will indicate volvulus, vomiting and acute abdominal pain – about acute appendicitis, and all these conditions require surgical intervention.

Problems with digestion are a common problem in childhood, therefore, with a slight diarrhea or single vomiting, urgent medical attention will not be needed. And if a child has a bad stomach ache, he cries and is in a bent position, this means that an ambulance team is indispensable. Parents should immediately write down data on whether there was vomiting, and if it is repeated, then after what interval it is repeated, when the stomach aches and whether the baby has an increase in body temperature – these data will help doctors to adequately assess the patient’s condition.

Dehydration is another problem that often occurs in children under 3 years of age. Moreover, this condition almost always occurs against the background of vomiting or increased body temperature – it is enough not to provide the baby with plenty of drink. Signs of dehydration in a child:

• pronounced pallor of the skin;
• less than 6 wet diapers per day, concentrated urine, orange;
• the smell of acetone appears;
• The child’s tongue and mucous membranes become dry;
• “fontanelle” sinks in children under the age of 1 year;
• in older children, headache may occur.

Symptoms of dehydration in a child include severe drowsiness or confusion, and other signs may be absent. Such a condition requires treatment in a hospital, but parents must do everything to prevent the onset of dehydration – for example, during an illness, the baby must drink a lot.

If the child has convulsions

Most often, seizures occur against a background of increased body temperature, and in this case, the child’s seizures will be classified as febrile.But the same syndrome can occur against the background of meningitis or any other infection that has affected the nervous system. Therefore, when the first seizures appear in the child, the parents should lay the child on its side and immediately call the ambulance team. Particular attention should be paid to the condition before a convulsive attack – the baby may have unjustified aggression, but he can also be as relaxed and asleep as much as possible: it is advisable to remember / write down all these nuances and inform the doctor.

By the way, a high temperature can lead to difficulty breathing in a child – the so-called shortness of breath requires qualified medical care.A bluish triangle appears around the child’s nose and upper lip, breathing becomes frequent and loud – this is a reason for contacting specialists. Often, shortness of breath appears only when the child takes a lying position – this may indicate the development of laryngeal edema.

Difficulty breathing in a child may also appear if a foreign body is swallowed. In this case, at night, the baby will cough strongly, often, but this will not bring him relief. If this continues for 2 days in a row, then you need to call the ambulance team – in the hospital, the baby will be x-rayed and the cause of breathing problems will be found out.

If a child suffocates, he has indomitable vomiting more than 5 times, the body temperature has increased greatly, there are convulsions, then this is the reason for seeking medical help. It is not worth stalling for time and trying to cope with the problem on your own – the lost minutes and hours can lead to the most sad outcome.

Based on materials from the site dobrobut.com

90,000 symptoms and treatment (note for parents)

Enterovirus infections – is a group of diseases that are caused by several types of viruses.The disease is caused by Coxsackie viruses, polioviruses and ECHO (echo).

After the transferred enterovirus infection, persistent lifelong immunity is formed, however, it is serospecific. This means that immunity is formed only to the serological type of the virus that the child has had and does not protect him from other varieties of these viruses. Therefore, a child can get sick with an enterovirus infection several times in his life. Also, this feature does not allow developing a vaccine to protect our children from this disease.The disease has a seasonality: outbreaks of the disease are most often observed in the summer-autumn period.

Reasons for infection with enterovirus infection.

Infection occurs in several ways. Viruses can enter the environment from a sick child or from a child who is a virus carrier. Virus carriers do not have any manifestations of disease, however, viruses are found in the intestines and are excreted in the environment with feces. This condition can be observed in children who have been ill after clinical recovery, or in children in whom the virus entered the body, but could not cause the disease due to the strong immunity of the child.Carriage of viruses can persist for 5 months.

Once in the environment, viruses can persist for a long time, as they tolerate adverse effects well. Viruses are well preserved in water and soil, when frozen, they can survive for several years, are resistant to the action of disinfectants (when exposed to solutions of high concentrations of phenol, chlorine, formalin, viruses begin to die only after three hours), but are susceptible to high temperatures (with when heated to 45 ° C, they die in 45-60 seconds).

How enterovirus infection is transmitted.

The transmission mechanism can be airborne (when sneezing and coughing with droplets of saliva from a sick child to a healthy one) and fecal-oral if personal hygiene is not followed. Most often, infection occurs through water, when using raw (not boiled) water. It is also possible to infect children through toys if children take them into their mouths. Most often, children aged 3 to 10 years old are ill. In children who are breastfed, the body has the immunity received from the mother through breast milk, however, this immunity is not persistent and after the cessation of breastfeeding quickly disappears.

Symptoms of an enterovirus infection.

Viruses enter the body through the mouth or upper respiratory tract. Once in the child’s body, the viruses migrate to the lymph nodes, where they settle and begin to multiply. The further development of the disease is associated with many factors, such as virulence (the ability of the virus to resist the protective properties of the body), tropism (the tendency to infect individual tissues and organs) of the virus and the state of the child’s immunity.

Enterovirus infections have both similar and different manifestations, depending on the type and serotype. The incubation period (the period from the entry of the virus into the child’s body until the first clinical signs appear) is the same for all enterovirus infections – from 1 to 10 days (usually 2-5 days).

The disease begins acutely – with an increase in body temperature to 38-39 ° C. The temperature most often lasts 3-5 days, after which it decreases to normal values. Very often the temperature has a wave-like course: the temperature lasts for 2-3 days, after which it decreases and for 2-3 days is at normal numbers, then rises again for 1-2 days and returns to normal again completely.When the temperature rises, the child feels weakness, drowsiness, headache, nausea, vomiting may occur. With a decrease in body temperature, all these symptoms disappear, but with a repeated increase, they can return. Also, the cervical and submandibular lymph nodes increase, as viruses multiply in them.

Depending on which organs are most affected, several forms of enterovirus infection are isolated. Enteroviruses can infect: the central and peripheral nervous systems, mucous membranes of the oropharynx, mucous membranes of the eyes, skin, muscles, heart, intestinal mucosa, liver; in boys, testicular damage is possible.

When the mucous membrane of the oropharynx is affected, enteroviral sore throat develops. It is manifested by an increase in body temperature, general intoxication (weakness, headache, drowsiness) and the presence of a vesicular rash in the form of bubbles filled with liquid on the mucous membrane of the oropharynx and tonsils. These bubbles burst, in their place are formed ulcers filled with white bloom. After recovery, no traces remain at the site of the ulcers.

With eye damage, conjunctivitis develops.It can be one- and two-sided. It manifests itself in the form of photophobia, lacrimation, redness and swelling of the eyes. The presence of hemorrhages in the conjunctiva of the eye is possible.

When the muscles are damaged, myositis develops – pain in the muscles. Pain appears against the background of an increase in temperature. Soreness is observed in the chest, arms and legs. The appearance of pain in muscles, like temperature, can be wavy in nature. With a decrease in body temperature, pain decreases or disappears altogether.

With the defeat of the intestinal mucosa (enteritis), there is a liquid stool.Stool of normal color (yellow or brown), liquid, without pathological (mucus, blood) impurities. The appearance of loose stools can be either against the background of an increase in temperature, or isolated (without an increase in body temperature).

Enterovirus infections can affect various parts of the heart. So when the muscle layer is damaged, myocarditis develops, when the inner layer is damaged with the capture of the heart valves, endocarditis develops, and when the outer shell of the heart is damaged, pericarditis. The child may experience: increased fatigue, weakness, heart palpitations, drop in blood pressure, rhythm disturbances (blockade, extrasystoles), chest pain.

With damage to the nervous system, encephalitis, meningitis may develop. The child has: severe headache, nausea, vomiting, fever, convulsions, paresis and paralysis, loss of consciousness.

With liver damage, acute hepatitis develops. It is characterized by an enlarged liver, a feeling of heaviness in the right hypochondrium, pain in this place. Perhaps the appearance of nausea, heartburn, weakness, fever.

With skin lesions, exanthema may appear – hyperemia (red coloration) of the skin, most often on the upper half of the body (head, chest, arms), does not rise above the level of the skin, appears instantly.

Boys may have inflammation in the testicles with the development of orchitis. Most often, this condition develops 2-3 weeks after the onset of the disease with other manifestations (tonsillitis, loose stools, and others). The disease passes rather quickly and does not bear any consequences, however, in rare cases, development of aspermia (absence of sperm) at puberty is possible.

There are also congenital forms of enterovirus infection, when viruses enter the child’s body through the placenta from the mother.Usually, this condition has a benign course and heals on its own, however, in some cases, an enterovirus infection can cause an abortion (miscarriage) and the development of sudden death syndrome in a child (the death of a child occurs against the background of full health).

Very rarely, damage to the kidneys, pancreas, and lungs is possible. The defeat of various organs and systems can be observed both isolated and combined.

Treatment of enterovirus infection

There is no specific treatment for enterovirus infection.Treatment is carried out at home, hospitalization is indicated in the presence of damage to the nervous system, heart, high temperature, which cannot be reduced for a long time with the use of antipyretic drugs. The child is shown bed rest for the entire period of increase in body temperature.

Meals should be light, rich in protein. A sufficient amount of liquid is required: boiled water, mineral water without gases, compotes, juices, fruit drinks.

Treatment is carried out symptomatically, depending on the manifestations of the infection – angina, conjunctivitis, myositis, loose stools, heart damage, encephalitis, meningitis, hepatitis, exanthema, orchitis.In some cases (angina, diarrhea, conjunctivitis …), bacterial complications are prevented.

Children are isolated for the entire period of the disease. The children’s team can be after the disappearance of all symptoms of the disease.

Prevention of enterovirus infection.

For prevention, it is necessary to observe the rules of personal hygiene: wash your hands after visiting the toilet, walking on the street, drink only boiled water or water from a factory bottle, it is unacceptable to use water from an open source (river, lake) for a child to drink.

There is no specific vaccine against enterovirus infection, since a large number of serotypes of these viruses are present in the environment.

Child’s temperature | Lipomal

Temperature is the natural protective instinct of the body, which, by increasing the body temperature, stimulates tissue immune mechanisms to fight infection. Given that the mechanism of thermoregulation in children is not fully formed, an increase in temperature is not always a symptom of the disease.It happens that a child may have a fever as a result of overheating or teething after vaccination.

Temperature Degree:

36 -37 ° C – normal temperature
37.1-38 ° C – mild temperature
38.1-39 ° C – moderate temperature
> 39 ° C – high temperature
It should be remembered that the temperature measured in the oral cavity higher by 0.3 ° C, in the rectum by 0.5 ° C from the measured temperature under the arm.

Reasons:

Temperature can usually cause illness, viral or bacterial infections, such as:

• colds, flu,
• tonsillitis, tonsillitis,
• otitis media,
• mumps, rubella, measles, chickenpox,
• scarlet fever,
• gastrointestinal infections,
• cystitis,
• meningitis

Symptoms

Typical symptoms of fever in children:

• redness, sweating
• rapid breathing (over 40 per minute) and heart rate (approx.120 / minute)
• headache
• feeling unwell, apathy
• warm skin (especially on the head and back)
• diarrhea (mainly in babies)
• febrile seizures may occur in children under 3 years of age

Methods for lowering the temperature:

The most popular folk methods for lowering the temperature are:

• cold compresses on temples, forehead, neck and calves
• cooling bath – water at the beginning is 1 ° C lower than body temperature, gradually decreasing to 32-30 ° C.
• care should be taken to keep the child’s room cool. To avoid dehydration, you need to water your baby frequently.

When to see a doctor?

A doctor should be called if:

• Fever occurs in infants up to 6 months
• high temperature persists for 1-2 days in children over 1 year old
• the temperature does not decrease, despite the use of antipyretic drugs
• febrile convulsions occurred
• The child does not want to drink enough fluids and is at risk of dehydration
• The child cannot tilt his head forward
• The child’s general well-being has significantly deteriorated
• The child is in severe pain

90,000 Genetics of febrile seizures (Feenstra, 2014)

STUDY TITLE: Common variants associated with generalized febrile seizures and seizures associated with MMR vaccine

SUMMARY: Identification of 6 genetic variants associated with febrile seizures .

OVERVIEW: In young children, high fever can cause seizures, causing uncontrolled tremors and loss of consciousness. This condition is known as febrile seizures and is a terrible experience for many parents. However, they are generally harmless and also fairly common, affecting 2–9% (depending on ethnicity) of children under 5 years of age. Because the illness is caused by a fever, they can occur after vaccination. Fever is a fairly common reaction to measles, mumps and rubella (MMR) vaccinations.Since little is known about the genetic predisposition to febrile seizures , particularly in response to the MMR vaccine, this study examined the genomes of nearly 9,000 European children to determine the contributing genetic factors. The study found 2 genetic variants associated with MMR-dependent febrile seizures and 4 more variants associated with the condition in general. One of the variants identified is adjacent to a gene that plays a role in the immune response to viral infections.Another variant is next to the gene that encodes receptor , which is used by the measles virus to enter cells.

DID YOU KNOW? Most children with febrile seizures do not need anti-seizure medication. The best way to manage a febrile seizure is to lay the baby on its side on a protected surface and watch carefully. However, it is important to understand the cause of the fever and treat it appropriately. [SOURCE]

SAMPLE RESULTS: Learn more about Nebula Research Library.

FEBRILE SEIZURE OPTIONS: rs114444506, rs6432860, rs273259, rs11105468, rs1318653, rs3769955

ADDITIONAL RESOURCES:
Febrile Seizure Fact Sheet
Febrile Seizures (Video)

WEEKLY UPDATE: April 21, 2020

90,000 Increased body temperature – SCCH

First aid procedure

Subfebrile temperature (up to 38 ° C)

1. Undress the child.
2. Rub with a damp cloth (slightly above room temperature).
3. Do not use antipyretics.

Febrile temperature (above 38 ° C)

1. Provide rest, put to bed.
2. Drink plenty of sweet tea, fruit drink.
3. Warm the child with chills (warm blanket, hot tea).
4. Give antipyretics.
5. At a temperature of 39.5-40 ° C, the child should not be wrapped.
6. Above 40.4 ° C, call emergency treatment and give antipyretic.

Specialist comment (pediatrician, candidate of medical sciences Gavrilova T.A.)

The normal temperature is not 36.6 ° C, as is often believed, but 36.0-37.0 ° C, in the evening it is slightly higher than in the morning. Body temperature rises in many diseases. The benefits of increased temperature are a signal of illness, a way to fight pathogens (many bacteria and viruses stop multiplying at temperatures above 37-38 ° C), this is a stimulus for an immune response, since a number of protective factors (incl.including interferon) are released only at temperatures above 38 ° C.
By lowering the fever, we do not affect the cause of the disease, but we can improve the well-being of the child.
Low-grade fever (up to 38 ° C) can appear when overheating, with a viral or bacterial infection. It is not worth taking antipyretics in such cases if the child’s well-being does not suffer.
At a “febrile” temperature (above 38 ° C), there is a narrowing of blood vessels, increased muscle contractions (hence – chills, tremors), in young children – convulsions (so-called “febrile” convulsions).
When the temperature rises to 39.5-40.0 ° C, the vessels of the skin expand (the skin turns red), such a child should not be wrapped up.
Fever is dangerous in case of vasospasm of the skin – this is malignant hyperthermia.
Her signs:

• temperature is above 40.4 ° C;
• variegated, “marble” color of the skin;
• limbs cold to the touch;

It is necessary to call emergency help and be sure to give an antipyretic agent, preferably in solution inside.

Antipyretics
Antipyretic drugs should be given to children at temperatures above 38.0 ° C, but if the child does not tolerate fever, worries, cries, or has had convulsions at an elevated temperature, antipyretics are given at temperatures above 37.5 ° C.Having given an antipyretic, one cannot calm down: be sure to consult a doctor (for recovery, you will need to take other drugs).
The main antipyretic agent recommended for children is PARACETAMOL (acetaminophen). It has no pronounced side effects, has anti-inflammatory and analgesic properties, relieves discomfort.
Paracetamol dose: 10-12 mg / kg of body weight per dose, 2-4 times a day (the daily dose should not exceed 40 mg / kg of body weight).A solution of paracetamol for oral administration acts quickly – after 20-30 minutes.
For a small child, it is better to use children’s dosage forms, for younger schoolchildren they use paracetamol tablets of 0.2 g, for older ones – 0.5 g each
Specially for children, CEFEKON D suppositories have been developed, they contain only paracetamol. The action of the candle begins in 30-60 minutes and lasts 5-6 hours.
Some antipyretic drugs have serious side effects and are therefore not used in children:

• acetylsalicylic acid (part of such as Aspirin, ASA, Askofen, Aspro-S, Citramon, effervescent tablets for colds, etc.) – with flu, acute respiratory viral infections, chickenpox can cause Reye’s syndrome (damage to the liver, brain).
• Analgin (part of such agents as Baralgin, Spazmalgon, etc.) – causes damage to the hematopoietic system.

Complications and reactions after vaccination Is there a difference? – Children’s Medical Center Pollyanna

Complications and reactions after vaccination! Is there a difference?

There are the most common vaccine reactions and vaccine complications.While there is no difference for most parents, you need to know how they differ.

Vaccination reactions are what parents and doctors most often face, that is, natural and expected reactions from a child who has received a vaccine. These include:

• fever, which occurs mainly on the first day after vaccination. A high temperature after 2 days from the vaccination is more often the result of ARVI on the day of the doctor’s visit.

• Local reaction in the form of redness or swelling (edema) at the injection site. It usually lasts for several days and goes away on its own. A severe reaction in the form of edema of more than 8 cm is very rare.

• Piercing crying for 3 hours or more is more often associated with nerve injury at the injection site. It passes without consequences.

Complications are unexpected and abnormal reactions of the body against the background or after the administration of the vaccine.There are several types of complications.

Complications due to individual sensitivity are the most common cause of reactions: allergic (rash, urticaria, shock), neurological (convulsions, encephalopathy).

Complications due to violation of the principles of vaccination: poor-quality vaccine, violation of storage or transportation of vaccines, violation of the technique of administering the vaccine or its dose.

Indirect situations associated with the introduction of vaccinations are also possible, for example, convulsions against the background of an increase in temperature after vaccination, i.e.That is, not for vaccination, but for a rise in temperature after vaccination.

Vaccination complications are serious and / or permanent health problems due to vaccination. These include:

• Vaccine-associated poliomyelitis is a rare but serious illness that occurs after vaccination with a live vaccine against poliomyelitis (the incidence rate, according to WHO, is 1 case per 1,000,000 vaccinated). In this regard, the issue of a complete transition to inactivated vaccines (non-living) is being resolved.

• Thrombocytopenia is a sharp and significant decrease in the number of platelets, which entails the risk of bleeding. Occurs after measles vaccination (3-4 cases per 100,000 vaccinated)

• Shock (anaphylaxis) may be related to vaccine components, but in most cases the cause is unclear. For DPT vaccine, the frequency is 1 case per 50,000 vaccinated, for other vaccines the risk is much less frequent – 1 case per 1,000,000 vaccinated. The reaction occurs after a few minutes, at least after 1-2 hours.

• Complications of BCG vaccination (tuberculosis) – ulcer, cold abscess, enlarged lymph nodes, even bone inflammation (osteomyelitis) with the release of mycobacterium tuberculosis from the inflammation focus. All complications of BCG occur in 85% with BCG vaccination and in 15% with BCG-M vaccination. Generalized BCGitis is a very serious illness of an immunocompromised child who has been vaccinated. It is extremely rare. Over the past 6 years, there have been 4 children in Russia.

Taking into account all possible complications and reactions, each responsible pediatrician must conduct a full examination of the child before vaccination, collect anamnesis, and also evaluate the results of blood and urine tests, and only then decide whether to vaccinate.

Lack of vaccinations can cause a serious infectious disease with various consequences, but the refusal of vaccination by parents will not affect the registration of the child in a child care institution, although in some cases it leads to certain restrictions.

Dear Parents! There is a lot of information even in this small article, and it is rather difficult to get adequate knowledge on the Internet without having a medical education. Therefore, if you have any questions or doubts, come to our clinic for qualified advice.

90,000 Roseola or three-day fever

Since a rash on the skin is an indispensable symptom of roseola, parents often turn to not only a pediatrician, but also a dermatologist.

Baby roseola has many names: sudden exanthema, three-day fever, pseudo-rubella. In many cases, it is not diagnosed as a separate disease, when the temperature rises, an acute respiratory viral infection is diagnosed, the rash is attributed to an allergy to drugs taken during the illness.

What is baby roseola?

Baby roseola is a viral disease characterized by a sharp rise in temperature, and then, after its decrease, the appearance of a small pink rash that spreads throughout the body. In the first three days, before the appearance of the rash, it is difficult to make a diagnosis, since there are no characteristic symptoms besides the temperature. It is the appearance of the rash that helps to determine that it is roseola.

This infection is transmitted presumably by airborne droplets, the incubation period is 9-12 days. Laboratory confirmation of the diagnosis is not required and, as a rule, no tests are performed. Usually children from 6 months to 3 years old are sick, mainly in the spring-autumn period.

What is the causative agent of this disease?

Most often, roseola is caused by the human herpes virus of the 6th type, less often of the 7th type.Herpes virus 6 (HHV-6) is very widespread, babies have antibodies from the mother at birth that protect it. Their level is significantly reduced by 4 months, and the baby becomes susceptible to infection. After 2 years, the immune system can already quite successfully cope with the virus, preventing the development of an acute illness. But in the interval, the body of children is most vulnerable, the peak incidence occurs at 6-12 months.

There is no specific prevention of roseola, of the general measures that reduce the risk of disease, one can note regular ventilation of the rooms where the child is, restrictions on close bodily contact with adults (you should not kiss a small child on the lips, nose, lick spoons and nipples, and so on ).

After a previous illness, stable immunity is developed , cases of re-infection are quite rare, but sometimes they occur. After 4 years, almost all examined children have antibodies to this virus.

Characteristic signs of the disease?

1. Temperature rise to 38 ° C-40 ° C without respiratory symptoms (runny nose, cough, sore throat) and rashes.An increase in temperature is the body’s response to the presence of a virus in the blood. On average, the temperature lasts 3 days.

2. Rash of small pale pink spots mainly on the neck and trunk, in smaller amounts on the face and limbs, 1-2 days after the cessation of the fever. A pale rim can often be seen around the elements of the rash.

3. The rash is not itchy and will go away on its own within a few days or weeks.

How does roseola differ from rubella?

In rubella, the rash appears simultaneously with the temperature, is located mainly on the limbs, slightly different in appearance. Also, rubella is not characterized by such a sharp and high rise in temperature.

Are there complications?

In the overwhelming majority of cases, the body copes independently and without consequences.High fever with sudden exanthema can cause febrile convulsions . As a rule, they are not dangerous, pass without consequences for the child and are not associated with damage to the nervous system or brain. But, if this happened for the first time, the child should be examined by a neurologist.

Sometimes there are concomitant symptoms in the form of inflammation in the nasopharynx and swollen lymph nodes. Very rarely, with an appropriate predisposition, neurological complications of the disease are possible: encephalitis, meningitis.

How is roseola treated?

The child should be examined by a pediatrician, since a high temperature can be not only with roseola, but also with other infectious diseases requiring treatment, for example, with otitis media, urinary tract infections.

There is no specific treatment for the roseola virus, so the treatment is symptomatic: antipyretics at high temperatures to relieve the child’s condition.While the temperature is holding, it is important to ensure that the child is consuming enough fluids. If the child refuses to eat, there is no need to force feed, as soon as the condition improves, the appetite will return.

When a rash appears, you do not need to lubricate it with something or take antiallergic drugs. The spots go away on their own without leaving traces, there may be slight peeling of the skin, which also goes away without treatment.