Don't panic with febrile seizures

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Febrile seizure in children: don't panic!

It is usually a shock for parents when they see when their child suddenly shrugs their whole body in fever, rolls their eyes and stops responding. It is particularly dramatic that it often affects the very young who have just outgrown infancy. But experts believe that this is no reason to panic.

Terrifying sight for parents It is not only terrifying for parents when a child with a fever suddenly rolls his eyes, stops responding and writhes in convulsions. If these are toddlers, however, there is often a febrile seizure behind it and this is usually harmless. The legal guardians should therefore not panic. Dr. Claudia Nußbaum, a doctor at the Hauners Children's Hospital in Munich, can understand the parents' fears, and so, according to press reports, she said: "Such an attack is very frightening for her." Ingo Borggräfe, senior physician for neuropediatrics and head of the department of children's epileptology at the epilepsy center of the Ludwig Maximillians University in Munich: "Most people think that this is life-threatening."

Call a doctor or go to the clinic for the first febrile seizure. However, epilepsy is extremely rare when toddlers have a fever and have a seizure with muscle twitching. Very often it is a febrile seizure. "This is almost never life-threatening," said Borggräfe. Especially in the winter months, when a particularly large number of children have a cold, the number of people affected increases. Most of these are children who are at least six months but not older than five years. About two to five percent of children with this age are affected by febrile seizures. According to Borggräfe, the age peak is 18 months. Even if these cramps are almost always harmless, the expert still advises parents to call a doctor or drive the child to the nearest clinic when a febrile seizure occurs for the first time. This is because an increased temperature is very often the cause of the seizure, but there could also be other causes behind it, which are associated with fever and must be treated quickly. For example, meningitis could also trigger a seizure.

Antipyretic drugs do not prevent febrile seizures. A doctor can usually rule out such an inflammation based on the symptoms and the circumstances of the seizure and therefore an examination of the nerve water is usually not necessary. Parents more often fear that their child's febrile seizure may be epilepsy. However, as Borggräfe thinks, this is almost never the reason for this. The suspicion can also be clarified with an electroencephalogram (EEG) in the rare cases where there is an indication. Doctors are usually released quickly if both epilepsy and meningitis have been excluded. Above all, it is limited to finding the cause of the fever. For example, if there is a bacterial infection, such as the middle ear, respiratory or urinary tract, it is treated with antibiotics. However, this could not prevent febrile seizures from occurring again, not even with antipyretic agents, explained Borggräfe. However, antipyretic measures are recommended in the event of an infection to promote the well-being of the child.

In the event of a seizure, put the children in a stable side position. For parents, it is particularly important to know how they should behave if they have a febrile seizure. You should then bring your child to the stable side position "or at least turn to the side", as Dr. Nussbaum explained. This as a safety measure if it breaks down. Above all, parents should not try to push something between their child's teeth, as can sometimes be seen on TV. This is dangerous because it can cause damage to the teeth or because children could inhale smaller objects, the doctor says. In addition, you should not try to infuse your child with liquid. Even if an attack usually stops after a few minutes, parents should look at the watch right from the start. If a febrile seizure lasts a long time, an emergency doctor should stop the attack with a medication. Seizures that last longer than a quarter of an hour or repeat within 24 hours are considered to be complicated.

Children lose the tendency to have seizures over the years. The reason why it affects the very little ones so often is probably due to the developmental stage in which their brains are at this stage of their lives. The healthy balance of messenger substances is particularly easy for children aged between six months and five years. In addition, fever makes the brain more susceptible to a seizure, explained Borggräfe. If the two come together, it can cause a febrile seizure. The disposition probably also plays a role. "Febrile seizures occur frequently in some families," says Nussbaum. In about 20 percent of cases, the sibling also has a febrile seizure if a child is already affected. For identical twins, the probability is even around 50 percent. Parents should expect their child to have another seizure if this has ever been the case. At least that is the case with about every third child. But the child will lose this tendency to seize as it gets older. As Borggräfe also calms down, the fear that a new attack will cause brain cells to die and the child may even be left behind in his mental development is unfounded.

Vaccination does not cause febrile seizure Nussbaum also said that vaccination was not the cause of a seizure. This against the background that some parents suspect vaccination as a trigger, because there are many vaccinations to be had especially in toddlers. At most indirectly, vaccination could lead to a febrile seizure, as some children react to it with a fever, which in turn could trigger an attack. "But not the vaccination itself," as Nussbaum explained. Even if parents cannot prevent another febrile seizure, they still have the option of having at least one emergency equipment available if the attack lasts longer than a few minutes. Only one drug in the form of a rectiole is approved for use in febrile seizures, which is inserted into the anus like an enema. As Borggräfe said, this was often difficult or not possible during an attack. Therefore, there is also an agent that is dripped into the mouth with a plastic syringe and absorbed through the mucous membrane. However, this is formally only approved for children with epilepsy and not for febrile seizures. (sb)

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