Febrile convulsion:Help your child through an attack

By Smriti Daniel

Watching your child go through a febrile convulsion can be terrifying and in such a situation parents tend to panic . But in this case, staying calm is your best hope and a key part of helping your child through such an attack. Mediscene speaks with Dr. Rohan Aloysius, a consultant paediatrician, about febrile convulsions and what parents should be prepared for.

What is a febrile convulsion and what causes it?

"A febrile convulsion is a convulsion that comes on with fever," says Dr. Aloysius, adding that children who have an attack range in age from roughly six months to six years. These convulsions come on without warning, beginning abruptly.

Though the causes are not very well understood, any illness which causes a fever (high temperature) can trigger a febrile convulsion in some children. For many, the fever is the result of a common illness such as an ear infection, cough, cold or flu.

What does a febrile convulsion look like?

A child having a convulsion will lose consciousness while his whole body jerks, he says. "Limbs tend to flex and extend," warns Dr. Aloysius, adding that sometimes the child's eyes will roll up and he will also froth at the mouth. Loss of bowel control may also occur.

"There are also atypical febrile convulsions where we have to investigate a bit more," he explains. Such convulsions are sometimes limited to only one side of the body, or may last more than 10 minutes. In addition, certain families have a history of being vulnerable to such epilepsy, warranting in depth investigations.

Treatment:

No treatment is usually required for a convulsion that stops within a few minutes (though the infection causing the fever will still need to be treated.)

However, once a convulsion begins, it is best to keep an eye on the time and rush the child to the doctor. If it does not stop within five minutes, the doctor will need to manage the fit and ensure it is treated quickly. "Mothers need to know the weight of the child," stresses Dr. Aloysius, "so that the doctor knows how much medication to give them." Medication is generally given through the rectum.

Importantly, Dr. Aloysius says parents must stay calm while bringing their child to hospital. In the rush, a child may fall or be hurt in some other way, further complicating the situation. Also once the fit is under control, it is important to rule out meningitis, he adds.

Dealing with fever

Controlling the fever is essential. If the fever rises, undress your child and gently sponge him or her down only with tepid tap water, recommends Dr. Aloysius. In addition, Paracetamol can be very effective. Care givers must keep in mind that the dosage depends on the weight of the child.

"It is generally 15 milligrams per kg," says Dr. Aloysius, adding that if the fever still does not fall then a dose of ibuprofen syrup must be administered. Relying on touch to decide whether a child has fever or not is strongly discouraged. A thermometer must always be used for accurate readings.

The future

Most children who have febrile convulsions do not have any long term health problems. In addition they will grow out of it by the age of six, reiterates Dr. Aloysius. Febrile convulsions do not cause brain damage, though the infection causing the convulsion may cause complications.

Despite knowing this, for a parent watching, the episode might be quite terrifying.

It helps to know that most children with febrile convulsions only ever have one. However, some may have recurring convulsions during or following episodes of high fever.

Risk of recurrence

There are two main factors that influence the likelihood of a recurrence, explains Dr. Aloysius. If the child has an attack at a comparatively "lesser temperature" (say 100 degrees Fahrenheit), and also if the child gets a convulsion "early on in the fever," he is more likely to have another convulsion. Febrile convulsions can be prevented only be controlling the fever, says Dr. Aloysius.