When a baby has a high fever, there is a risk of developing seizures. Most parents are aware of this. Why this happens, how likely it is and how to provide the baby with first aid, we will tell you in this material.
What it is?
Convulsive muscle contractions during fever are common in children. Adults do not suffer from such a complication of high fever. Moreover, the likelihood of developing seizures decreases over the years. So, adolescents do not have them at all, but in infants from birth and in babies under 6 years of age, the risk of reacting in this way to fever and fever is great like no one else. The peak of the disease occurs in children aged from six months to one and a half years.
Seizures can develop with any illness that is accompanied by a significant rise in body temperature.
Critical in terms of the likelihood of febrile seizures is considered a temperature that exceeds subfebrile values when the thermometer rises beyond 38.0 degrees. Rarely enough, but this is not excluded, seizures "start" at 37.8-37.9 degrees.
The likelihood that a child will develop such an unpleasant symptom is not very high. According to statistics, only one of 20 toddlers with high fever is prone to convulsive syndrome. In about a third of cases, febrile seizures return - if a child once experienced them, then the risk of a second seizure with another illness with fever and fever is about 30%.
The risk group includes children who were born prematurely, low birth weight, babies with pathologies of the central nervous system, children born as a result of rapid childbirth. However, these statements are nothing more than the assumption of doctors and scientists. The true risk factors are still unknown.
True, one thing is known for certain - seizures with a high degree of probability in high heat can appear in children whose parents or relatives in the second and third generations suffer from epilepsy or other convulsive ailments and conditions.
Thus, genetic predisposition plays a decisive role.
How are they developing?
At a high temperature, the child's internal temperature rises, including the temperature of the brain. The "overheated" brain itself is capable of a wide variety of "tricks", but more often than not, it simply begins to send the wrong signals to the muscles, which begin to involuntarily contract.
The question of how high temperature provokes convulsive syndrome is one of the most controversial in medical science. The researchers did not come to a consensus. In particular, it is still unclear whether prolonged febrile seizures can trigger the epilepsy process in a child. Some scientists claim that these ailments are in no way related to each other, although they are similar in symptoms, others see a certain connection.
It is obvious that the age-related immaturity of the children's nervous system and the imperfection of its work are related to the mechanism of the development of seizures. That is why, when it develops sufficiently, closer to the end of preschool age, one can forget about febrile seizures, even if before this age they were repeated with enviable constancy with every illness in which the temperature rose.
Causes
The causes that underlie febrile seizures are still being studied, it is difficult to judge them for certain. However, provoking factors are known. High fever in a child can cause infectious and non-infectious diseases. Common infections include:
viruses (ARVI, influenza, parainfluenza);
bacteria (staphylococcal infection, scarlet fever, diphtheria, etc.);
fungi.
Non-infectious causes of fever with a likelihood of developing seizures:
teething;
heatstroke, sunburn;
deficiency of calcium and phosphorus in the body;
postoperative fever;
neurogenic fever;
severe allergic reaction;
trauma;
reaction to the DPT vaccine (occurs infrequently).
Symptoms
Febrile seizures do not develop immediately, but only a day after the temperature is set at high values. By themselves, convulsive contractions are simple and complex. Simple convulsions last from a few seconds to 5-15 minutes, during which all muscles contract evenly, a short-term loss of consciousness occurs, after which the baby usually cannot remember what happened and falls asleep quickly enough.
Complex febrile seizures are manifested by contractions and convulsions of individual limbs or only one half of the body. Attacks with atypical seizures are long-lasting - more than a quarter of an hour.
If simple convulsions are usually single, not recurring during the day, then atypical ones can return several times a day.
What do they look like?
A febrile seizure always begins suddenly, without any preconditions or precursors. The child simply loses consciousness. The lower limbs are the first to be subject to convulsive contractions. Only then does the spasm cover the body and arms. The child's posture in response to convulsive contractions changes and becomes characteristic - the baby arches his back and throws his head back.
The skin becomes pale, cyanosis may appear. Cyanosis usually appears in the area of the nasolabial triangle, and the eye sockets also look sunken. Short-term respiratory arrest may occur.
The child comes out of the attack smoothly, all symptoms develop in the reverse order. First, the natural color of the skin returns, the cyanosis of the lips, dark circles under the eyes disappears, then the posture is restored - the back straightens, the chin drops. Last but not least, the cramps of the lower extremities disappear and consciousness returns to the child.... After an attack, the baby feels tired, overwhelmed, apathetic, he wants to sleep. Drowsiness and fatigue persists for several hours.
First aid
Without exception, all parents of babies need to know the rules of first aid in case the child suddenly starts having febrile seizures:
Call an ambulance and to record the time of the onset of the seizure, this information will be very important for the arrived team of doctors in order to differentiate seizures and decide on further treatment.
Lay the child on its side. Check that there is nothing foreign in the baby's mouth so that he does not choke. If necessary, the oral cavity is cleaned. The lateral position of the body is considered a universal "rescue posture", it prevents possible aspiration of the airways.
Open all vents, window, balcony door, to provide fresh air as soon as possible.
From the place where the child lies, you should remove all sharp, it is dangerous that he, in convulsions, could not be accidentally injured. It is not necessary to hold the baby's body by force, it is also fraught with injury to muscles, ligaments, bones. It is enough to slightly hold and observe so that the child does not hurt himself.
- Parents need to remember in as much detail as possible or to film all the features of the attack, while the ambulance team is traveling - does the baby have a reaction to others, to light, loud sounds, voices of parents, uniform or uneven contractions of the limbs, how intense is the convulsion. This information, together with the exact time of the seizure duration, will help the doctor to quickly understand the situation, make the correct diagnosis, exclude an epileptic seizure, meningitis and a number of other health-threatening diseases that are also accompanied by convulsive syndrome.
What should not be done during an attack?
If seizures appear, in no case should you do the following:
Spray the child with cold water, immerse him in a cold bath, apply ice to the body. This can cause vasospasm and complicate the situation.
Straighten limbs with convulsions, forcibly unbend an arched back. This can result in injuries to bones, tendons, joints, spine.
Smear the child with fats (badger, bacon), alcohol (and vodka too). This disrupts thermoregulation, which leads to even more severe overheating of the brain.
Insert a spoon into the child's mouth. The general opinion that a baby without a spoon can swallow his own tongue is nothing more than a common philistine delusion. It's impossible to swallow your tongue in principle.
Thus, there is no benefit from a spoon, but the harm is great - in attempts to unclench the teeth of a child with convulsions, parents often break their teeth with a spoon, injure the gums. Debris from teeth can easily enter the respiratory tract and cause mechanical suffocation.
Give artificial respiration. An unconscious child continues to breathe, even if there are short-term respiratory stops. You shouldn't interfere with this process.
Pour water or other liquids into the mouth. In an attack, the child cannot swallow, therefore, it is necessary to water his liquid only when the baby is conscious. Attempting to pour water or medicine into the mouth during febrile seizures can be fatal to the baby.
First aid
First aid from the arrived doctors of the "ambulance" will consist in the emergency administration of seduxen solution. The dosage can be different and is taken at the rate of 0.05 ml for each kilogram of the child's weight. The injection is done intramuscularly or into the sublingual space - into the bottom of the mouth. If there is no effect, then after 15 minutes another dose of seduxen solution will be administered.
After that, the doctor will begin to interview the parents in order to find out the nature, duration and features of the convulsive syndrome. Visual examination and clinical presentation will help rule out other diseases. If the seizures were simple and the child is over a year and a half, doctors may leave him at home. In theory. On practice hospitalization is offered to all children at least for a day, so that doctors can make sure that the child will not have repeated seizures, and if they occur, the baby will immediately receive qualified medical care.
Treatment
In a hospital setting, a child who has experienced an attack of febrile seizures will undergo the necessary diagnostic examinations, the purpose of which is to identify violations of the central nervous system, peripheral nervous system and other pathologies. They will take blood and urine from him for tests, babies under one year old will definitely have an ultrasound of the brain through the "fontanelle", an ultrasound scanner will allow you to consider the size and features of the brain structures. Children older with a tendency to frequent attacks will be prescribed a computed tomogram.
If the attack recurs, the child will be injected intramuscularly with a 20% solution of sodium oxybutyrate in a dose depending on the weight of the baby - from 0.25 to 0.5 ml per kilogram. The same drug can be administered intravenously with a 10% glucose solution.
If earlier children after febrile seizures were prescribed long-term use of anticonvulsants (in particular, "Phenobarbital"), now most doctors are inclined to believe that these drugs are more harmful than potential benefits. In addition, it has not been proven that taking anticonvulsants has any effect on the possibility of recurrence of seizures in the next illness with a fever.
Consequences and forecasts
Febrile seizures are not particularly dangerous, although they seem extremely dangerous to parents. The main danger is in the delayed assistance and in common mistakes that adults can make when providing emergency care. If everything is done correctly, then there is no risk to the life and health of the baby.
Allegations that febrile seizures affect the development of epilepsy do not have a sufficient convincing scientific basis. Although some studies show a definite connection between prolonged and frequent recurrent seizures against a background of high fever and the subsequent development of epilepsy. However, it is especially emphasized that epilepsy in these children also has a genetic background.
A child who suffers from seizures with every illness with an increase in temperature usually completely gets rid of this syndrome after reaching the age of six.
The link between mental and physical developmental delay and febrile convulsive syndrome also seems to be insufficiently proven to doctors.
Can you be warned?
Although pediatricians advise to monitor the temperature of the child in case of illness and give him antipyretic drugs with the formulation “to avoid seizures”, it is impossible to avoid febrile attacks. There are no preventive measures to guarantee that there will be no seizures. If a child has a genetic predisposition, then neither shock doses of antipyretics nor constant measurements of body temperature will save him from an attack.
Experiments conducted in a clinical setting have shown that children who took antipyretic drugs every 4 hours and children who did not take antipyretic drugs are equally susceptible to febrile seizures.
If febrile seizures have already happened once, then the child simply needs increased control. Parents should be prepared for the development of convulsive syndrome at any time of the day, even at night in a dream. Follow the above scheme of emergency care.
For information on what to do with febrile seizures in children, see the next video.
