A febrile seizure, also known as a fever fit or febrile convulsion, is a convulsion associated with a significant rise in body temperature.

They most commonly occur in children between the ages of 6 months and 6 years and are twice as common in boys as in girls.[1][2] Causes The direct cause of a febrile seizure is not known; however, it is normally precipitated by a recent upper respiratory infection or gastroenteritis. A febrile seizure is the effect of a sudden rise in temperature (>39C/102F) rather than a fever that has been present for a prolonged length of time.[2] As well as this, parents caring for children who may be febrile, wrap them up in warm blankets in an attempt to comfort the child, unknowingly increasing their fever and therefore the problem. Febrile seizures occurring in children between the ages of 6 months and about 6 years can be due to a hypersensitive hypothalamus in the brain. The hypothalamus is responsible for homeostatic core temperature regulation, (amongst other factors) and in younger children it is still a developing portion of the brain, meaning it is susceptible to hypersensitive reactions to slight raises in body temperature. Febrile seizures represent the meeting point between a low seizure threshold (genetically and age-determined; some children have a greater tendency to have seizures under certain circumstances) and a trigger, which is fever. The genetic causes of febrile seizures are still being researched. Some mutations that cause a neuronal hyperexcitability (and could be responsible for febrile seizures) have already been discovered.[citation needed] Several genetic associations have been identified.[3] These include: Diagnosis The diagnosis is one that must be arrived at by eliminating more serious causes of seizure and fever: in particular, meningitis and encephalitis must be considered. However, in locales in which children are immunized for pneumococcal and Haemophilus influenzae, the prevalence of bacterial meningitis is low. If a child has recovered and is acting normally, bacterial meningitis is very unlikely. The diagnosis of a febrile seizure should not prevent evaluation of the child for source of fever, although this is usually limited to evaluation of the urine in the younger age groups. Types There are two types of febrile seizures.

Symptoms During simple febrile seizures, the body will become stiff and the arms and legs will begin twitching. The patient loses consciousness, although their eyes remain open. Breathing can be irregular. They may become incontinent (wet or soil themselves); they may also vomit or have increased secretions (foam at the mouth). The seizure normally lasts for less than five minutes.[8] Treatment The vast majority of patients do not require treatment for either their acute presentation with a seizure or for recurrences. The best way to manage is to control the temperature with acetaminophen (Paracetamol) or by sponging. When anticonvulsant therapy is judged by a doctor to be indicated, anticonvulsants can be prescribed. Sodium valproate or clonazepam are active against febrile seizures, with sodium valproate showing superiority over clonazepam.[9] Definition -Convulsion means abnormal muscular contractions of either epileptic or non-epileptic origin. Causes of convulsions I. Acute convulsions: With fever: Febrileconvulsions, due to causes outside CNS e.g., tonsillitis, otitis media, .etc. Intracranial infections: e.g., brain abscess, meningitis, encephalitis. Without fever: Trauma : e.g., intracranial heamorrhage. Toxins / poisons : e.g., lead poisoning. Anoxia / ischemia : e.g., respiratory failure, hypotension. Metabolic : e.g., hypoglycemia, hypocalcemia. II. Chronic convulsions (recurrent) i.e., epilepsy Primary (idiopathic). Secondary: Post infectious, e.g., after meningitis. Post toxic, e.g., kernicterus. Post-traumatic, e.g., intracranial heamorrhage. Degenerative brain diseases. Post-anoxic. Febrile convulsions: Febrile convulsions (FC) occurs as a result of infection outside the CNS or to high environmental temperature in a child who is neurologically normal. Febrile convulsion occurs at age from 6 months to 6 yrs. Males are affected more than females. If febrile convulsion is not treated, there is high rate of recurrence, especially in the 1st yr or two after onset. Causes of Febrile convulsions: The exact cause is unknown, but 1/3 of cases have positive family history of febrile convulsion. Febrile convulsion occurs at the peak of fever or with sudden rise in temperature. It always occurs in the 1st 24 hrs of febrile illness. Each seizure is generalised and only one seizure in 24 hrs period. The EEG (electroencephalogram) is normal. Therapeutic management of Febrile convulsions: Control convulsions by anticonvulsive drugs. Lower body temperature by tepid sponge or tub bath and antipyretics. Treat the cause of infection, e.g., antibiotics for otitis media. Nursing care of Febrile convulsions: Nursing diagnosis of Febrile convulsions

A simple febrile seizure is one in which the seizure lasts less than 15 minutes (usually much less than this), does not recur in 24 hours, and involves the entire body (classically a generalizedtonic-clonic seizure). A complex febrile seizure is characterized by longer duration, recurrence, or focus on only part of the body. The simple seizure represents the majority of cases and is considered to be less of a cause for concern than the complex.
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Simple febrile seizures do not cause permanent brain injury; do not tend to recur frequently (children tend to outgrow them); and do not make the development of adult epilepsy significantly more likely (about 35%), compared with the general public (1%). [5] Children with [6] febrile convulsions are more likely to suffer from a febrile epileptic attacks in the future if they have a complex febrile seizure, afamily history of a febrile convulsions in firstdegree relatives (a parent or sibling), or a preconvulsion history of abnormal neurological signs or developmental delay. There is an 80% chance that children who have complex febrile seizures will have seizures later on in life. Similarly, the prognosis after a simple febrile seizure is excellent, whereas an increased risk of death has been shown for complex febrile seizures, partly related to underlying conditions.[7]

1- hyperthermia / alteration in body temperature. 2- high risk for injury related to convulsions. 3- high risk for fluid volume deficit related to hyperthermia. 4- knowledge deficit related to febrile convulsion management. Nursing interventions of Febrile convulsions The nurse should: Provide safety measures. Reduce fever using tepid bath (no alcohol or ice is added) either in bed or in tub. If tub is used the nurse must : - use warm water first, then cold water gradually to prevent chilling. - give the bath for 20-30 min. - use floating toy to divert the young childs attention. - older child can help in bathing. - dry childs skin after bathing. Monitor temperature every half an hour. Offer fluids every hour if child is awake. Observe signs and symptoms of dehydration. Teach parents about : - signs and symptoms of fever. - measures to reduce fever. - how to administer anti-convulsive drugs. What is a febrile convulsion? Febrile convulsions occur in young children when there is a rapid increase in their body temperature. It affects up to 1 in 20 children between the ages of one and four but can affect children between six months and about five years old. Children who are at risk may naturally have a lower resistance to febrile convulsion than others. What is the risk of suffering a febrile convulsion? Children may inherit the tendency to suffer febrile convulsion from their parents. If either parent suffered a febrile convulsion as a child, the risk of the child getting it rises 10 to 20 per cent. If both parents and their child have at some point suffered a febrile convulsion, the risk of another child getting it rises 20 to 30 per cent. Nevertheless, the child's susceptibility also depends on whether the child frequently gets infections. About 4 out of 10 children who have had febrile convulsions will get them again at some stage, although the risk differs greatly from child to child. The child's risk of febrile convulsion rises if: they are genetically predisposed to it they suffer frequent illnesses, which include high temperatures the first attack of febrile convulsion was accompanied by a relatively low body temperature - below 39C. One in a thousand children may suffer a febrile convulsion after receiving the MMR (measles, mumps, rubella) vaccine. In these cases it occurs 8 to 10 days after the vaccination and is caused by the the measles component of the vaccine. However, this causes only about one tenth of cases of febrile convulsion compared withmeasles itself. Children who are prone to febrile convulsions should follow the same programme of vaccination as all other children. What are the symptoms? The attack often begins with the child losing consciousness, and shortly afterwards the body, legs and arms go stiff. The head is thrown backwards and the legs and arms begins to jerk. The skin goes pale and may even turn blue briefly. The attack ends after a few minutes and the shaking stops. The child goes limp, and then normal colour and consciousness slowly return. Some children regain consciousness faster than others. What to do if your child suffers an attack of febrile convulsion

Do not intervene while the attack is taking place except in the circumstance outlined below. Carefully turn the child's head to one side to prevent choking. In the past, it was common to place a stick in the child's mouth to prevent bites to the tongue or lips. This should never be attempted, as it may result in lasting damage to the teeth. When the fit subsides, keep the child in the recovery position, ie lying on its side. If fits are prolonged or follow each other rapidly, call an ambulance. The first time a child suffers febrile convulsions they should be admitted to hospital. If the child has suffered attacks on earlier occasions, hospitalisation is not always necessary. However, it is always important, for example, to determine whether the convulsions are only due to a harmless viral infection. For this reason, a doctor should always be consulted following an attack. Has the child previously suffered febrile convulsions? If the child has a history of febrile convulsions, parents are sometimes advised to have the medicine diazepam ready in case an attack takes place. It can be given into the rectum from a specific rectal tube and takes effect in a few minutes. If the attack goes on for more than five minutes treatment can be repeated, but medical advice should always be sought in any prolonged fit. Dosage instructions must be carefully adhered to. Does the child have a temperature? Make sure the child is not too hot by removing extra clothing or bedclothes. If the room temperature seems high, open a window, but bear in mind that the child should not get too cold either. Give the child plenty of cold drinks. Some doctors advise parents to give the child mild painkillers such asparacetamol (eg Calpol) or ibuprofen (eg Nurofen for children). This lowers the temperature by between 1 and 1.5C. It is important to give the recommended dose only. Although febrile convulsions look like epileptic fits, they rarely have anything in common with this illness. Ninety-nine per cent of children who have had a febrile convulsion have no more fits after they reach school age. Future prospects Although febrile convulsion often seems frightening, it rarely results in any permanent injuries. If, however, the convulsions last a long time or the child suffers several attacks in quick succession, slight disturbances in the brain function may occur. If your child has had a febrile convulsion, consult your GP on the best way to deal with them. Half of all sufferers will have another attack the next time they have a temperature. But the risk lessens with time and attacks should not occur after the age of about five. Is it possible to prevent febrile convulsion? Temperature-lowering medicines, such as paracetamol, can help lower body temperature but need to be repeated. If not, the temperature will rise rapidly again. If your child has suffered febrile convulsion in the past, your doctor may advise you to have special enemas containing diazepam on standby.