Fever Seizures (Febrile Convulsions)

While sat in the front lobby of a state hospital in Denpasar, I saw a father with his children in his arms hurriedly rushing into the emergency room. Curious, I ventured to ask the father what had happened to his son, his voice still panting heavily, father was told that his son was hit by step.

Step or seizures fever is very common in children. According to IDAI, events febrile seizures in children aged 6 months to 5 years of almost 2 - 5%. Seizure is a frightening thing, but usually not dangerous. Parents will panicked once get a child suffered a febrile seizure.

What is a fever seizures? Fever seizures are seizures that occur when an infant or child has a fever without any infection of the central nervous system. Febrile seizure occurred at the beginning of fever. Children will look strange for a while, then stiff  and rolled her eyes. Child is unresponsive for some time, breathing will be disturbed, and the skin will appear darker than usual. After the seizure, the child will soon return to normal. Seizures usually lasted less than 1 minute, but although rare can occur for more than 15 minutes.

In general, fever seizures can be divided into two types, namely:

• Simple febrile seizures (seizures fever Simplified): overall seizure that lasted <15 minutes and not recurring within 24 hours.
• Complex febrile seizures / complex partial seizures (seizures fever complex): focal seizures (involving only one part of the body), lasted> 15 minutes, and / or repeated in a short time (during the fever lasted).

So what distinguishes this febrile seizures with epilepsy? Although the same symptoms of seizures, and recurrent, but in children who suffer from epilepsy, episodes of seizures are not accompanied by fever.

There are several factors that influence the occurrence of recurrent febrile seizures include:

• Age <15 months during the first febrile seizure.
• History febrile seizures in the family
• Seizures fever occurs immediately after starting a fever or when the temperature was relatively normal
• History of fever is often
• The first seizure was complex febrile seizures

If the seizure occurs soon after a fever or if the body temperature is relatively low, it will likely happen again febrile seizures. Risk of recurrence of febrile seizures is 10% with no risk factors, 25% with 1 risk factor, 50% with 2 risk factors, and can reach 100% with = 3 risk factors.

What if your child's fever caused by immunization? Although immunization can cause fever, but rarely followed immunization febrile seizures. A study conducted showed the risk of febrile seizures in several types of immunization as follows:

• DTP: 6-9 per 100,000 immunizations. This risk is high on the day of immunization, and declined thereafter.
• MMR: 25-34 per 100,000 immunizations. The risk increases at 8-14 days after immunization.

Febrile seizures after immunization did not have a recurring tendency greater than febrile seizures in general. And febrile seizures after immunization is unlikely to be repeated in subsequent immunization. So febrile seizures is not a contra indication immunization.

Actually, what happens in the body when children have a febrile seizure? 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.

Viewing events in the body's exposure to the above, I pull the red thread symptoms you can see when the child has seizures Fever, among others: the child has a 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.

When children have seizures Fever, it is important that we should do include:

• If your child has a febrile seizure, quickly acted to prevent injuries.
• Put your child on the floor or bed and away from hard objects or sharp
• Turn head to one side so that saliva (spit) or vomit to flow out of the mouth
• Do not put anything in the mouth of the patient. Your child will not swallow his own tongue.
• Contact your child's doctor

Finally, the question arises how to prevent your children do not experience seizures fever, as I wrote above seizures can 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).  With proper handling and fast, travel well and are not disease causing death.