Fever and twitching: Febrile seizures: Why they happen and when they can be serious

12.06.202214.07.2023 by alexxlab

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Febrile seizures: Why they happen and when they can be serious

Fevers can be concerning for any parent. But if your child also starts to jerk or twitch their body or lose consciousness, it can make things even more worrisome. When a high fever accompanies jerking or twitching, these are common signs of a febrile seizure.

Febrile seizures can be scary to witness, but they’re usually short-lived and harmless. However, some children can develop epilepsy, a brain disorder that causes recurring, unprovoked seizures. Read on to learn more about febrile seizures and what to do if your child experiences one.

What are febrile seizures, and what causes them?

Febrile seizures occur in children, typically between 3 months to 6 years old, and are triggered by a fever above 100.4 F. The fever may accompany common childhood illnesses, such as a cold, the flu or an ear infection. If a seizure develops with a fever of less than 100.4 F, this could be a sign of epilepsy or another seizure disorder.

There is also a slight tendency for febrile seizures to run in families. If you or another close relative have a history of seizures, your child may be more likely to have them. Additionally, studies show a small increased risk for febrile seizures following certain childhood vaccines, such as the measles, mumps, and rubella or varicella (chickenpox) vaccines.

What are the symptoms of a febrile seizure?

A child having a febrile seizure may:

Have a fever higher than 100.4 F (38.0 C)
Shake all over
Twitch or jerk their arms and legs
Lose consciousness

Febrile seizures are usually brief, lasting anywhere from a few seconds to a couple of minutes. It could be something serious if your child experiences a longer seizure.

The following signs may indicate something more serious:

Recurring seizures or more than one seizure in a 24-hour period
Vomiting
Stiff neck
Trouble breathing or turning blue
Trouble waking up or excessive sleepiness after a seizure

What should I do if my child experiences a febrile seizure?

A febrile seizure should be handled like any other seizure. If your child has a febrile seizure, remain calm and:

Gently place your child on the floor or the ground.
Remove any nearby objects.
Place your child on their side to prevent choking.
Loosen any clothing around their head and neck.
Watch for signs of breathing problems, including bluish color on the face.
Try to keep track of how long the seizure lasts.

Things not to do during a febrile seizure:

Do not try to hold or restrain your child.
Do not put anything in your child’s mouth.
Do not try to give your child fever-reducing medicine.
Do not try to put your child into cool or lukewarm water to cool off.

When the seizure is over, it’s a good idea to take your child to the doctor to find out the cause of the fever if it’s unknown. The doctor will likely examine your child and ask you to describe the seizure. In most cases, seizure treatment is not necessary. However, your doctor may refer your child to a brain specialist, or neurologist, for further testing and an evaluation. The neurologist may order an electroencephalograph, also known as an EEG, to monitor the electrical activity in your child’s brain or magnetic resonance imaging, also known as MRI, to look at the structure of your child’s brain.

When to call 911

Get emergency medical care if your child:

Has a seizure that lasts longer than three minutes – convulsive seizures lasting longer than five minutes can cause brain damage
Has trouble breathing or begins turning blue
Isn’t responding normally after the seizure

If your child has another seizure within 24 hours, it may not be necessary to call 911. However, it’s best to be evaluated by a doctor as soon as possible.

“Most seizures are short-lived because our brains have the ability to effectively extinguish seizures, including febrile and non-febrile seizures,” says Nebraska Medicine neurologist Olga Taraschenko, MD, PhD. “But if your child experiences convulsions that last longer than three minutes, or you notice other severe symptoms, such as difficulty breathing or a stiff neck, it’s important to seek medical help. ”

Concerned about seizures?
Call 800.922.0000 to schedule an appointment.

How do you get epilepsy?

Epilepsy commonly occurs in two groups: children born with the disease and adults who develop it due to degenerative diseases or trauma. Learn more.

With right treatment, most epilepsy patients can live normal lives

Treatment and management of epilepsy continues to improve. With the right diagnosis and treatment, most patients can live a normal life.

My battle with epilepsy: Free of seizures, helping others

It was March 6, 1998, my freshman year of high school. My childhood dream had come true, and I was just finishing my first season on the high school basketball

Febrile (Fever) Seizures: Symptoms, Causes, Treatment

Written by WebMD Editorial Contributors

Who Gets a Febrile Seizure?
What Does It Look Like?
What Causes Them?
How Can I Help My Child?
Should I Get Emergency Help?
Will It Happen Again?
Can My Child Be Treated?
Do Febrile Seizures Cause Other Problems?
More

If your child ever had a febrile (fever) seizure, it’s something you probably won’t forget. But while these 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.

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.

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, including lab work, imaging, a spinal tap or even a hospital admission

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:

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.

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 as long as the seizure lasts less than a few minutes and your child is breathing/stable. 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.

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.

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.

Your doctor may prescribe longterm anti-seizure 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. This in an acute seizure medication to administer of seizure lasts greater than 5 minutes.

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 simple febrile seizure. A simple febrile seizure should not cause any long-term consequences.

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Febrile convulsions in children | Rassvet Clinic

Febrile convulsions (attacks) are episodes of convulsions in children accompanied by high fever.

Seizure may occur up to 4%:

in a child aged 6 months to 5 years with no prior neurological problems;
when the temperature rises above 38 ⁰C.

What can cause an attack?

Infections that cause fever. Infection can be caused by bacteria, but febrile seizures are more common with viral illnesses (eg, roseola and influenza).

Vaccinations followed by fever. There is a small chance of febrile seizures after vaccination against measles, rubella and mumps, as well as diphtheria, tetanus and whooping cough. But the risks from incomplete vaccination are higher than the risk from a febrile seizure after vaccination.

Heredity. If either parent has had a febrile seizure, the child is more likely to have a fever seizure.

A febrile seizure, especially when it occurs for the first time in life, is very frightening for parents. In fact, most of these attacks are not dangerous, do not lead to complications and damage to the brain. A child with a simple febrile seizure is only marginally more likely to develop epilepsy than a child who has never experienced a febrile seizure.

What does a simple febrile seizure look like?

The child loses consciousness, does not respond, may roll his eyes up.
Arms and legs twitch rhythmically, this happens symmetrically on both sides.
The attack usually lasts less than a minute, but in some cases – up to 5 minutes.
After an attack, the child may be drowsy for an hour, but does not feel weakness in the arm or leg and gradually returns to normal.

What are complex febrile seizures? How are they different from normal ones?

In this type of febrile seizure, the seizure may begin with a twitch of one arm (leg) or with a turn of the head to one side (asymmetry).

An attack may last longer than 15 minutes, or attacks may recur several times a day.
An attack can occur at a relatively low temperature, below 38 ⁰C.
After an attack, there may be prolonged drowsiness, weakness in one arm or leg.

How to help a child during an attack?

Lay the baby on its side on a flat surface and make sure that the child does not fall or hit anything during the cramp (eg the crib bars).
Time yourself and tell your doctor when the attack started and how long it lasted.

Attention! Do not try to open the jaw, do not put anything in the child’s mouth during an attack, this can lead to injuries (broken teeth of the child and injured fingers of the caregiver).
Do not try to restrict the movement of the child during convulsions, do not restrain him.

The child may be even more afraid of an attack than the parents. Try to calm him down, support him.

If the seizure occurs for the first time in life, lasts longer than 5 minutes, the child is unusually drowsy and lethargic before or after the seizure, call an ambulance.

In other cases, take the child to the pediatrician without delay. The doctor should examine the child after the attack and make sure that he does not have signs of a central nervous system infection (meningitis or encephalitis).

What tests are done after a febrile seizure?

In most cases, a doctor’s examination is sufficient to make this diagnosis. If meningitis is suspected, a lumbar puncture is performed. Sometimes the doctor may order urine and blood tests if the cause of the high fever is not clear.

In case of complex seizures, electroencephalography and MRI are scheduled. These studies are necessary because this type of febrile seizure may be a manifestation of rare epileptic syndromes that require anticonvulsant treatment.

How to treat a fever in a child who has previously had a febrile seizure?

If the child does not have a fever during illness or after vaccination, it is not recommended to give antipyretics! It does not reduce the risk of an attack.

If the fever is high, drugs to reduce it make you feel better overall, but do not help the attacks.

The harm of anticonvulsants for the prevention of febrile seizures outweighs the benefits, they are almost never prescribed.

If the child’s febrile seizures are prolonged, it is recommended to administer a benzodiazepine enema, nasal spray, or cheek gel at the onset of the seizure. Such forms have only recently been registered in Russia, but, unfortunately, they have not yet entered the market. Therefore, if the attack lasts longer than 5 minutes, the emergency doctor can give an injection of such a medicine.

For antipyretics, children can be given ibuprofen 10 mg/kg every 8 hours or paracetamol 15 mg/kg every 6 hours. Do not give children aspirin!

Probability of recurrence of febrile seizures

After the first simple febrile seizure in life, recurrent seizures occur in ⅓ of children. A second attack usually occurs within 2 years after the first.

The likelihood of a recurrence of a febrile seizure is higher if:

the first seizure was before the age of 15 months;
the attack occurred at a temperature less than 38 ⁰C;
parents, brother or sister also had febrile convulsions;
the child goes to kindergarten.

Important to know

Parents often mistake febrile seizures for normal fever-related chills. With such a chill, the child’s hands and feet may tremble rhythmically. It is similar to convulsions, but the child is conscious and responds if spoken to. So that the doctor can better understand whether the incident was convulsions, and if so, which ones, try to clearly fix the duration of the attack, describe it as specifically as possible, and ideally, record what is happening on video (one person helps the child, the second shoots on the phone).

Author:

Dmitrieva Olga Borisovna
pediatric neurologist

High fever and febrile convulsions in a child: causes, symptoms, treatment

Children’s Medical Center “Pediatrician and Me”
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Articles
High fever and seizures in a child: is it dangerous?

Is there any benefit to having a high temperature?
Febrile convulsions

Causes of febrile seizures
Symptoms of febrile convulsions

What should I do if my child has a high temperature?

When to give medicine?
High fever treatment
What should not be done when the temperature is high?

An increase in body temperature in children occurs under the influence of various factors. Toxins, viral and bacterial infections, inflammatory and autoimmune diseases that have entered the body can provoke a fever. High temperature is accompanied by malaise, intoxication and causes panic in parents. What to do if the child has a high temperature and how to help the baby?

Is there any benefit to having a high temperature?

Fever in children is not as bad as parents think. In fact, this is the body’s immune response to foreign agents entering the bloodstream: viruses, bacteria, toxins, and others. In most cases, fever is short-lived and resolves on its own within 2-4 days.

Do not confuse fever with heat illnesses that cause fever, such as heat stroke. In this situation, the body temperature can rise to a critical level of 45 degrees and poses a direct threat to the life of the child.

High temperature due to illness:

inhibits the reproduction of pathogenic microorganisms;
enhances immune response;
promotes accelerated recovery.

However, this does not mean that it is not necessary to monitor the temperature during illness. Every child has a different reaction to a fever. If some children tolerate elevated levels well, then others develop febrile convulsions and other complications against the background of high temperature. That is why pediatricians recommend to closely monitor the well-being of the baby if his body temperature has risen above 38 degrees.

Febrile seizures

Febrile seizures are benign seizures that occur against the background of fever when the body temperature rises to 38 degrees and above. Against this background, there is a violation of the activity of brain neurons, which leads to convulsions.

Most often the disease occurs in children aged 6 months to 6 years. The peak of the disease occurs at the age of 1.5 years. Most often, boys suffer from febrile seizures. Pathology has a favorable prognosis and usually resolves with age.

Causes of febrile seizures

The exact mechanisms of febrile seizures in children are unknown. One of the factors is the immaturity of the CNS. Doctors also believe that pathology can be hereditary. Most often, seizures occur in babies whose parents suffered from a similar condition in childhood.

Convulsions can be provoked by any factors leading to an increase in body temperature. These include:

viral and bacterial infections;
diseases of the gastrointestinal tract;
diseases of the respiratory system;
teething;
reaction to routine vaccinations;
dehydration;
endocrine diseases, etc.

In most children, convulsions occur within the first day after the body temperature rises to 38 degrees and above.

Symptoms of febrile convulsions

In subfebrile convulsions, the child loses consciousness, he has seizures that manifest themselves in the form of twitches or body tension. This is a harmless condition that does not cause any changes in the central nervous system and does not indicate serious problems. Most children have seizures on their own.

In 90% of cases, low-grade seizures are benign, but in the remaining 10%, atypical or complex seizures may develop.

The distinguishing features of simple subfebrile seizures include:

duration up to 15 minutes;
no recurrence within 24 hours;
rare episodes;
absence of epilepsy in relatives or parents;
normal development of the child;
the presence of episodes of subfebrile convulsions in close relatives.

Atypical subfebrile convulsions have the following clinical picture:

last more than 15 minutes;
often repeated during the day;
occur against the background of cerebral palsy, motor or psychoverbal developmental delay.

Also, atypical seizures often occur in children whose heredity is aggravated by epilepsy.

To prevent the development of subfebrile convulsions, it is necessary to monitor the child’s body temperature during illness. Also, if you have seizures, you should consult a pediatrician.

What should I do if my child has a high temperature?

If the child has a high fever and the child tolerates it well enough, it is not necessary to immediately give him antipyretics. To begin with, it is necessary to free the child from excess clothing and provide access to fresh air, while avoiding drafts is important. To reduce fever, cold compresses applied to the elbows and knees in the area of large blood vessels can be used.

The need for medication to lower the temperature is considered individually for each child. It is important to understand that the baby is most difficult to endure intoxication, and not the fever itself. That is why maximum efforts should be directed to combat the symptoms of intoxication. Drinking plenty of water or taking sorbents will help to cope with this.

When to give medicine?

Doctors recommend giving antipyretics to children when the temperature rises above 38 degrees. However, there are situations when it is impossible to postpone taking medications. These include:

Poor temperature tolerance. The child may not sleep well, be capricious, refuse to eat and drink even at a temperature of 37.6.
CNS diseases. These include epilepsy, cerebral palsy, meningitis, the consequences of previous infections. In this case, it is necessary to give an antipyretic when the temperature rises to 37.5 degrees.
Uncharacteristic behavior on the background of fever. The baby may experience hallucinations, delirium, and irritability against the background of temperature.
Respiratory disorders. Fever can cause shortness of breath, a state of lack of air.
Fluid loss. The presence of vomiting and diarrhea against the background of high temperature leads to a rapid loss of fluid in the body. In this case, the child refuses to drink.
Tendency to low-grade convulsions. In such a situation, it is necessary to give antipyretics already at a temperature of 37.5 degrees.
Body temperature over 39 degrees. In such a situation, it is imperative to bring down the heat, since high temperature has a negative effect on many body systems.

Treatment of high fever

Non-steroidal anti-inflammatory drugs such as ibuprofen or paracetamol are recommended for children with high fever. They quickly reduce the temperature and are just as quickly excreted from the body.

In childhood, it is best to use drugs in the form of rectal suppositories. Antipyretics in the form of tablets have much more side effects and are less absorbed by babies. With rectal administration, the active components of suppositories quickly spread through the body with blood flow. This eliminates the negative impact of the components on the stomach, and you can use candles regardless of the meal.

What should not be done when the temperature is high?

In order not to aggravate the child’s condition, during a high temperature it is strictly forbidden:

Warmly dress the child, and also wrap him in a blanket in order to “sweat”. Also, you can not take the baby to the bath, and even more so to soar him.
Wipe the baby’s body with alcohol-containing compounds, even diluted with water. Alcohol will lower the temperature of the skin, but not the body as a whole.
Give different drugs without interruption if suddenly one of them does not help. In this case, you can provoke a serious poisoning, which will give an additional burden on the body.
Exceed the dosage of antipyretics or use them in a course every 6-8 hours, even if the body temperature does not rise again.
Use analgin, nimesulide or aspirin to control fever. Aspirin use in children can lead to the extremely rare but fatal Reye’s syndrome.
Give medication and try to bring down the temperature until it drops to 36. 6.

It is very important to monitor the well-being of the child during a fever. If the baby feels well, does not refuse food and drink, it is worth waiting with taking antipyretics.

If the temperature persists for more than 5 days, it is important to consult a pediatrician for advice. Also, the help of a doctor is necessary if the fever intensifies, and the drugs do not have the desired effect. To fight high fever, you need to find out its cause. This requires a comprehensive examination and laboratory tests.

The article was written under the editorship of an expert, pediatrician, doctor of the highest category Storcheus Natalia Yurievna. To undergo the treatment mentioned in the article materials, you need to contact a specialist. The information in the article is not a call for self-treatment!