Overview Seizures are a common occurrence in children. 8% will have at least one seizure by 15 years of age. A seizure is the result of an abnormal paroxysmal discharge by cerebral neurons. Many underlying conditions and neurological challenges may provoke seizures, and in over 50% of children seizures are isolated events associated with either a fever (febrile seizures/convulsions) or minor head injury in early childhood.
Seizures can be classified as focal or generalised
A febrile seizure refers to an event in infancy or childhood, usually occurring between three months and six years of age, associated with fever but without evidence of intracranial infection or defined cause. Affects 3% of children under 5 years with unknown aetiology
Generally accepted criteria for febrile seizures include:
Definition Seizure: sudden attack of altered behaviour, consciousness, sensation or autonomic function produced by a transient disruption of brain function. The result of this altered brain function is most commonly a tonic (stiffening) or tonic-clonic (stiffening-jerking) seizure. Epilepsy: common set of variable conditions with recurrent seizures. Presents when at least 2 unprovoked seizures occur >24 hours apart. Convulsions: a seizure with motor accompaniments Non Febrile convulsion (seizures): These are seizures occuring without presence of a fever. There are many causes one of which is epilepsy. Febrile Convulsions: a seizure without other known cause occurring between 6 months and 6 years of age with fever |
Remember Children with a fit and fever may have meningitis |
Side note Epilepsy and febrile seizures have different classifications |
Risk Factors |
Age |
High Fever |
Viral infection |
Recent immunizations |
Family history |
Remember Child returns to normal after a postictal period |
Remember While meningitis and encephalitis are the main concerns in a child presenting with fever and seizures, a thorough history and examination will almost always detect the child with meningitis |
Management
Remember In a simple febrile convulsion, where the focus of infection can be identified, blood tests and invasive investigations are often NOT indicated. |
Complications
Prognosis
Watch Febrile Seziures |