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Febrile convulsion--an overview
Arabinda Mukherjee1, Asha Mukherjee
1Vivekananda Institute of Medical Sciences, Kolkata.
Insights
Febrile convulsions are common in young children and do not lead to epilepsy. While frightening, these fever-related seizures are generally benign and have a genetic component.
Area of Science:
- Pediatrics
- Neurology
- Genetics
Background:
- Febrile convulsion is the most common epilepsy syndrome in infants and children aged 6 months to 5 years.
- Risk factors include family history, prolonged neonatal nursery stay, developmental delay, and daycare attendance.
Purpose of the Study:
- To summarize the understanding of febrile convulsions, including risk factors, diagnosis, management, and prognosis.
- To emphasize the benign nature of febrile convulsions and their lack of causal relationship with subsequent epilepsy.
Main Methods:
- Literature review and synthesis of current medical knowledge on febrile convulsions.
- Exclusion of other acute neurological illnesses for diagnosis.
- Management strategies for acute attacks and parental counseling.
Main Results:
- Single febrile convulsions do not increase the risk of epilepsy; no causal link exists.
- A significant genetic component influences susceptibility to febrile seizures.
- Management involves airway management, positioning, vital sign monitoring, and medications like diazepam or lorazepam.
Conclusions:
- Febrile convulsions are a benign condition, despite being frightening for parents.
- Phenobarbital is not effective for preventing febrile convulsions when administered during a fever.
- Genetic factors play a crucial role in the susceptibility to febrile seizures.
Abstract:
Febrile convulsion is the most frequently occurring epilepsy syndrome, experienced in infants/children between 6 months and 5 years of age associated with fever >38 degrees C. Children having first or second degree relative with history of febrile convulsion, neonatal nursery stay of more than 30 days, developmental delay or attendance at day care centre are at increased risk of developing febrile convulsion. Single febrile convulsion does not increase the risk of epilepsy and there is no causal relationship between febrile convulsion and subsequent epilepsy. It has been recognised that there is significant genetic component for susceptibility to febrile seizures. To make the diagnosis of febrile convulsion, meningitis, encephalitis, serious electrolyte imbalance and other acute neurologic illnesses are to be excluded. While managing acute attack the steps to be taken are--airway management, a semi-prone position to avoid aspiration, monitoring vital signs and other supportive care. Diazepam or lorazepam is the drug to be used. There is no reason to expect phenobarbitone administered at the time of fever to be effective in prevention of febrile convulsion. The parents should be counselled about the benign nature of the convulsion. Although the febrile convulsion a frightening event, still it is a benign condition.