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Please help to describe about Febrile seizure

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Description about Febrile seizure

Febrile seizure

• Febrile seizures are seizures or convulsions that occur in young children and are triggered by High fever.
• Young children between the ages of about 6 months to 5 years old are the most likely to experience febrile seizures; this risk peaks during the second year of life.

Febrile seizures usually are related to fever higher than 102°F (38.8°C).

Types

There are two types of febrile seizures.

Simple febrile seizures last fewer than 15 minutes, do not recur within 24 hours, and are generalized (i.e., affect a widespread area of the body). Following a simple febrile seizure, the child may be drowsy or confused for a short period of time.

Complex febrile seizures last longer than 15 minutes, recur within 24 hours, or are focalized (i.e., affect a specific area of the body). Complex febrile seizures can occur as a result of a serious illness, such as meningitis (inflammation of the membranes that surround the brain and spinal cord) or encephalitis (brain inflammation). Children who experience complex febrile seizures have a slightly higher than normal risk for developing epilepsy.

Incidence and prevalence

Febrile seizures, which affect approximately 3 percent of children, are most common between the ages of 6 and 18 months.

A child's first febrile seizure rarely occurs before the age of 3 months or after the age of 3 years.

Boys have a slightly higher risk for febrile seizures than girls.

About 30–50 percent of children who have a febrile seizure experience an additional seizure.

Risk factors and etiology

• Age (occurs between the ages of 3 months and 5 years)
• Developmental delays (e.g., cerebral palsy, mental retardation)
• Family history of seizure disorders
• Frequent fevers (e.g., caused by viral or bacterial infection)
• High fever (above 102°F)
• Maternal smoking and alcohol use during pregnancy (further research is needed to confirm this link)
• Meningitis (inflammation of the membranes that surround the brain and spinal cord)
• Personal history (i.e., previous febrile seizure)

Certain pathogens

• Influenza A virus, which causes the flu,
• Human herpesvirus 6 (HHV-6), which causes roseola, and Shigella
• Campylobacter bacteria, which cause gastroenteritis (e.g., diarrhea, nausea, vomiting, fever).

Childhood immunizations and urinary tract infections (UTIs) also may increase the risk.

Signs and symptoms of febrile seizure

Febrile seizures usually last fewer than 5 minutes; however, they may last from a few seconds to 15 minutes or longer.

During a febrile seizure, children are unable to respond (i.e., unresponsive) and may lose consciousness. If the child is standing, he or she will fall.

Other symptoms of febrile seizures include the following:

• Breathing difficulty (e.g., apnea; the child may turn bluish in color)
• Contraction of the muscles of the face, limbs, and trunk
• Fever (usually higher than 102°F)
• Illness (e.g., upper respiratory infection)
• Involuntary moaning, crying, and/or passing of urine
• Shaking
• Twitching
• Vomiting

After a period of time (usually a few seconds to a few minutes), the muscles relax, causing rhythmic jerking. Once the seizure is over, the child may be sleepy or confused.

Diagnosis of Febrile Seizures

When a febrile seizure occurs, parents and caregivers should contact the child's pediatrician immediately. Diagnosis may involve a history of symptoms and a thorough physical examination, including a neurological exam.

In some cases, laboratory tests (e.g., blood tests, urine tests, lumbar puncture) are performed to rule out other possible causes for the seizure, such as dehydration (e.g., caused by severe vomiting and/or diarrhea) and meningitis and determine the cause for the fever.

Blood tests that may be performed include a complete blood count (CBC) and blood cultures. These tests are used to detect viruses or bacteria and high levels of white blood cells, which may indicate infection.

In some cases, a lumbar puncture (also called a spinal tap) is performed to rule out meningitis.

Medical management

Non-pharmacological management

During the time of the seizure activity

If your child has a febrile seizure, try to stay calm. The following steps can help the child avoid injury and other complications during a febrile seizure:

• Do not move the child unless he or she is in a dangerous location (e.g., near the top of the stairs).
• Remove any harmful objects from the area (e.g., sharp or heavy objects that may fall on your child) and loosen or remove clothing from the waist up (to help prevent choking).
• Do not try to restrain the child.
• If saliva, vomit, or mucus builds up in your child's mouth, turn the child onto his or her side. If the child is having difficulty breathing, call 911 immediately.
• Do not try to give the  child anything by mouth. Do not put anything into the child's mouth to prevent the child from biting his or her tongue.
• Watch for signs of breathing difficulty (e.g., changes in the color of the child's face).
• Apply a cool (not cold) washcloth to help reduce the fever. Do not put the child into the bath.

Ask the patient attenders about the complete incidence, signs and symptoms of the seizure activity.

An acetaminophen suppository (which is inserted into the child's rectum) often reduces fever quickly and may be recommended. Do not give your child aspirin, as it increases the risk for a serious condition called Reye syndrome.

Continuous therapy with phenobarbital or valproate decreases the occurrence of subsequent febrile seizures.

In many cases, no additional treatment is required following a febrile seizure. However, if the child experiences complex febrile seizures, has other serious symptoms, or is younger than 18 months old, further testing and treatment, including hospitalization for observation, may be necessary.

Nursing management

Nursing Interventions

Nursing interventions appropriate for the patient are:

• Check underlying factors. Assess underlying condition and body temperature.
• Monitor vital signs. Monitor and record vital signs.
• Provide cold compresses. Provide a description of the family regarding the provision of compress; cold compresses can reduce body temperature.
• Wear light clothing. Give light clothing that can absorb sweat to facilitate the release of heat into the air.
• Regulate activity. Promote adequate rest periods to reduce metabolic demands or oxygen.
• Increase fluid intake. Advice to increase fluid intake to help decrease body temperature.
• Discuss diet. Discuss eating habits and encourage diet for age to achieve health needs of the patient with the proper food diet for his disease.
• Improve tissue perfusion. Elevate head of bed at night to increase gravitational blood flow.

Complications of febrile seizure

• If the child is standing, eating, or drinking when the seizure occurs, he or she may be injured by the fall, may choke, or may inhale fluid into the lungs.
• The child also may bite his or her tongue, lips, or inside of the cheek during a febrile seizure.

Febrile Seizure Prognosis

• Most children recover completely from febrile seizures, without long-lasting complications.
• Although frightening for parents and caregivers, simple febrile seizures usually are harmless.
• Complex febrile seizures may indicate a more serious medical condition and increase the risk for epilepsy slightly.

Health education for the prevention of Febrile Seizure

• Febrile seizures cannot always be prevented.
• Limiting exposure to viruses that cause upper respiratory infections (e.g., by frequent hand washing and avoiding contact with anyone who is sick) may help reduce the risk for illnesses that cause fever, but this has not been proven to reduce the risk for febrile seizures.
• Parents and caregivers should follow the advice of a qualified health care provider regarding the use of fever-reducing medicines (e.g., acetaminophen, ibuprofen) in young children.
• In children who are prone to febrile seizures, a medication called diazepam may be administered orally or rectally when fever is present to help prevent seizures.
• Side effects of this medication include hyperactivity, drowsiness, and lack of coordination.