Febrile Convulsions

Febrile seizures, in medical terms known as febrile convulsions, a spasm resurrection happened on the increase in body temperature (rectal temperature> 38 oC), without infection in the central nervous system and other neurological disorders.

The cause of the occurrence of certain febrile seizures is unknown. Febrile seizures associated with fever are sudden high and mostly occurs on the first day the child has a fever.

A child who have a febrile seizure, does not mean he suffered from epilepsy for epilepsy characterized by recurrent seizures that are not triggered by a fever.

Risk Factors

Febrile seizures occur in children aged between 6 months-5 years and rarely occurs before age 6 months and after 3 years.

Factors that influence the occurrence of recurrent febrile seizures:
1. Age when first infected febrile seizure (less than 15 months) often experience fever
2. Family history who also suffered from febrile seizures.
3. If the seizure occurs soon after a fever or if the body temperature is relatively low, it will likely happen again febrile seizures.

Pathophysiology

In the state of fever, 1 oC increase in temperature will result in an increase in basal metabolism of 10% – 15% and 20% oxygen requirement. As a result there is a change of balance of brain cell membranes and occur within a short time diffusion of potassium ions and sodium ions through the membrane before, resulting in loss of electrical charge.
Loss of electrical charge large enough to extend to the whole cell / cell membrane with the help of nearby neurotransmitters, resulting in seizures. Seizures were mostly coincided with the increase of high temperature and rapid infection outside the central nervous system, such as tonsillitis (inflammation of the tonsils), ear infections, and other respiratory tract infections.
Seizures usually stop myself. Once the seizure stops, the child does not give any reaction for a moment, but a few seconds / minutes later the child will wake up and realize again without neurological disorders. Febrile seizures are generally brief and do not cause dangerous symptoms remaining. But prolonged seizures (> 15 minutes) is very dangerous and can cause permanent brain damage.

Symptoms and sign febrile seizures

Symptoms include fever (especially fever or body temperature increase occurs suddenly), tonic seizures, or grand mal klonik, fainting which lasted for 30 seconds-5 minutes (almost always occurs in children who have a febrile seizure).
Tonic posture (contraction and overall muscle stiffness that usually lasts for 10-20 seconds), klonik movement (contraction and relaxation of muscles strong and rhythmic, usually lasts for 1-2 minutes), bitten tongue or cheek, teeth or jaw clenched, incontinence (urine out or feces outside consciousness), respiratory disorders, apneu (stopping breathing), and bluish skin.

Prevention of febrile seizures

Seizures may occur if the body temperature rises or falls rapidly. In most cases, seizures occur unexpectedly or can not be prevented. Formerly used anti-seizure drugs as a preventive measure in children who often have a febrile seizure, but this is rarely done.
In children who tend to have a febrile seizure, when they had a fever can be given diazepam (either by mouth or by rectal).

Management of these patients are:

Stop seizures as soon as possible, with the provision of diazepam as the drug of choice, can be parenteral or suppository. (This is expected to take the patient to the doctor / medical service immediately).
Medical Investigations, all tight clothing opened, the position of the head should be tilted to prevent vomit stomach contents into the lungs, is also prophylactic measures against the possibility of subsequent seizures.
With proper handling and fast, travel well and are not disease causing death.

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