BFC- Benign Febrile Convulsion

A febrile seizure, also known as a fever fit or febrile convulsion, is

an epileptic seizure associated with a high temperature but without any serious
underlying health issue. They most commonly occur in children between the
ages of 6 months and 5 years. Most seizures are less than five minutes in
duration and the child is completely back to normal within sixty minutes of the
even
Signs and Symptoms
During generalized febrile seizures, the body will become stiff and the
arms and legs will begin twitching. The child 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. [2] The child's
temperature is usually greater than 38 degrees Celsius.
Causes
Febrile seizures are due to fevers, usually those greater than 38 C
(100.4 F). The cause of the fevers is often a viral illness. The likelihood of a
febrile seizure is related to how high the temperature reaches. Some feel that the
rate of increase is not important while others feel the rate of increase is a risk
factor. This latter position has not been prove
Diagnosis
The diagnosis is arrived at by eliminating more serious causes
of seizure and fever: in particular, meningitis and encephalitis. However, in
locales
in
which
children
are
immunized
for
pneumococcal
and Haemophilusinfluenzae, the prevalence of bacterial meningitis is low. If a
child has recovered and is acting normally, bacterial meningitis is very unlikely
Types
There are three types of febrile seizures.

A simple febrile seizure is characterized by shorter duration (lasting less than 15

minutes), no focal features (meaning the shaking is general rather than restricted
to a part of the body such as an arm or leg), and if they do occur in series, the

total duration is less than 30 minutes (classically a generalized tonic-clonic

seizure).

A generalized febrile seizure, also known as a complex febrile seizure, is one in

which the seizure lasts longer than 15 minutes or multiple episodes occur within
24 hours and generally does have focal features.

A febrile status epilepticus is a febrile seizure that lasts for longer than 30
minutes. It can occur in up to 5% of febrile seizure cases.

Prevention
In
those
with
a
history
of
febrile
seizures,
neither antipyretic or anticonvulsant medications have been found effective for
prevention; however, some appear to be associated with harm. They are thus not
recommended as an effort to prevent further seizures
Treatment
The vast majority of people do not require treatment for either their acute
presentation
or
for
recurrences
In
those
who
have prolonged
seizures intravenous lorazepam is recommended. The other benzodiazepines
midazolam and diazepamare also reasonable options.
Prognosis
Long term outcomes are generally good with little risk of neurological
problems or epilepsy. Those who have one febrile seizure have an approximately
40% chance of having another one in the next two years, with the risk being
greater in those who are younger.
Simple febrile seizures 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%). Children with
febrile convulsions are more likely to have a febrile seizure in the future if they
were young at their first seizure (less than 18 months old), have a family
history of a febrile convulsions in first-degree relatives (a parent or sibling), have
a short time between the onset of fever and the seizure, had a low degree of
fever
before
their
seizure,
or
have
a
seizure
history
of

abnormal neurological signs

or developmental
delay.
Similarly,
the prognosis after a complex febrile seizure is excellent, although an
increased risk of death has been shown for complex febrile seizures, partly
related to underlying conditions.

Epidemiology
Febrile seizures happen between the ages of six months and five
years. They affect between 2-5% of children. Rates between 5 and 10% have
been reported in India and Japan